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Effects of the Affordable Care Act on Health Behaviors After 3 Years

Author

Listed:
  • Charles Courtemanche

    (University of Kentucky
    National Bureau of Economic Research
    Institute of Labor Economics (IZA))

  • James Marton

    (Georgia State University)

  • Benjamin Ukert

    (Leonard Davis Institute of Health Economics, University of Pennsylvania)

  • Aaron Yelowitz

    (University of Kentucky)

  • Daniela Zapata

    (IMPAQ International)

Abstract

This paper examines the impacts of the affordable care act (ACA)—which substantially increased insurance coverage through regulations, mandates, subsidies, and Medicaid expansions—on behaviors related to future health risks after 3 years. Using data from the Behavioral Risk Factor Surveillance System and an identification strategy that leverages variation in pre-ACA uninsured rates and state Medicaid expansion decisions, we show that the ACA increased preventive care utilization along several dimensions, but increased risky drinking. These results are driven by the private portions of the law, as opposed to the Medicaid expansion. We also conduct subsample analyses by income and age.

Suggested Citation

  • Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2019. "Effects of the Affordable Care Act on Health Behaviors After 3 Years," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 45(1), pages 7-33, January.
    • Handle: RePEc:pal:easeco:v:45:y:2019:i:1:d:10.1057_s41302-018-0119-4
    DOI: 10.1057/s41302-018-0119-4
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    Cited by:

    1. Charles J. Courtemanche & Ishtiaque Fazlul & James Marton & Benjamin D. Ukert & Aaron Yelowitz & Daniela Zapata, 2019. "The Impact of the ACA on Insurance Coverage Disparities After Four Years," NBER Working Papers 26157, National Bureau of Economic Research, Inc.
    2. Lindsey Rose Bullinger, 2021. "Child Support and the Affordable Care Act's Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(1), pages 42-77, January.
    3. Jonathan Gruber & Benjamin D. Sommers, 2019. "The Affordable Care Act’s Effects on Patients, Providers and the Economy: What We’ve Learned So Far," NBER Working Papers 25932, National Bureau of Economic Research, Inc.
    4. Courtemanche, Charles & Marton, James & Ukert, Benjamin & Yelowitz, Aaron & Zapata, Daniela, 2018. "Effects of the Affordable Care Act on Health Behaviors after Three Years," IZA Discussion Papers 11468, Institute of Labor Economics (IZA).
    5. Sarah Miller & Norman Johnson & Laura R Wherry, 2021. "Medicaid and Mortality: New Evidence From Linked Survey and Administrative Data," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 136(3), pages 1783-1829.
    6. Dunn, Abe & Knepper, Matthew & Dauda, Seidu, 2021. "Insurance expansions and hospital utilization: Relabeling and reabling?," Journal of Health Economics, Elsevier, vol. 78(C).
    7. Yichen Shen & Haruko Noguchi, 2021. "The effect of coverage of smoking‐cessation aids on tobacco use: Evidence from Canada," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2200-2216, September.
    8. Chun Yee Wong & Shugo Shinohara, 2024. "Impacts of Copayment Change on Health Behaviours for Older People: Evidence from a Japanese Health Policy Reform," Working Papers EMS_2024_03, Research Institute, International University of Japan.
    9. Aparna Soni, 2020. "The effects of public health insurance on health behaviors: Evidence from the fifth year of Medicaid expansion," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1586-1605, December.
    10. Burney, Shaheer & Boehm, Rebecca L. & Lopez, Rigoberto A., 2018. "Impact of the 2014 Medicaid Expansion on SNAP Participation," 2018 Annual Meeting, August 5-7, Washington, D.C. 273847, Agricultural and Applied Economics Association.
    11. Prabal K. De, 2021. "Impacts of insurance expansion on health cost, health access, and health behaviors: evidence from the medicaid expansion in the US," International Journal of Health Economics and Management, Springer, vol. 21(4), pages 495-510, December.
    12. Lindsey Rose Bullinger & Maithreyi Gopalan & Caitlin McPherran Lombardi, 2023. "Impacts of publicly funded health insurance for adults on children's academic achievement," Southern Economic Journal, John Wiley & Sons, vol. 89(3), pages 860-884, January.
    13. Jeffrey Clemens & Drew McNichols & Joseph J. Sabia, 2020. "The Long-Run Effects of the Affordable Care Act: A Pre-Committed Research Design Over the COVID-19 Recession and Recovery," NBER Working Papers 27999, National Bureau of Economic Research, Inc.
    14. Yelowitz, Aaron & Ingram, Samuel J., 2021. "How Does Occupational Licensing Affect Entry into the Medical Field? An Examination of EMTs," IZA Discussion Papers 14071, Institute of Labor Economics (IZA).
    15. Charles J. Courtemanche & James Marton & Aaron Yelowitz, 2019. "Medicaid Coverage across the Income Distribution under the Affordable Care Act," NBER Working Papers 26145, National Bureau of Economic Research, Inc.
    16. Gopalan, Maithreyi & Lombardi, Caitlin McPherran & Bullinger, Lindsey Rose, 2022. "Effects of parental public health insurance eligibility on parent and child health outcomes," Economics & Human Biology, Elsevier, vol. 44(C).

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    More about this item

    Keywords

    Affordable care act; Health insurance; Medicaid; Health behavior; Preventive care;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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