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The Long-Term Effect of Health Insurance on Near-Elderly Health and Mortality

Author

Listed:
  • Bernard Black

    (Northwestern University, Pritzker School of Law and Kellogg School of Management)

  • José-Antonio Espín-Sánchez

    (Yale University, Department of Economics)

  • Eric French

    (University College London, Department of Economics, and Federal Reserve Bank of Chicago)

  • Kate Litvak

    (Northwestern University, Pritzker School of Law)

Abstract

We use the best available longitudinal data set, the Health and Retirement Study, and a battery of causal inference methods to provide both central estimates and bounds for the long-term effect of health insurance on health and mortality among the near-elderly (initial age 50–61) over a 20-year period. Compared with matched insured persons, those uninsured in 1992 consume fewer health-care services, but their health (while alive) does not deteriorate relative to the insured, and, in our central estimates, they do not die significantly faster than the insured. Our upper and lower bounds suggest that prior studies have greatly overestimated the health and mortality benefits of providing health insurance to the uninsured.

Suggested Citation

  • Bernard Black & José-Antonio Espín-Sánchez & Eric French & Kate Litvak, 2017. "The Long-Term Effect of Health Insurance on Near-Elderly Health and Mortality," American Journal of Health Economics, University of Chicago Press, vol. 3(3), pages 281-311, Summer.
    • Handle: RePEc:ucp:amjhec:v:3:y:2017:i:3:p:281-311
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    File URL: https://www.journals.uchicago.edu/doi/pdf/10.1162/AJHE_a_00076
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    1. Richard K. Crump & V. Joseph Hotz & Guido W. Imbens & Oscar A. Mitnik, 2009. "Dealing with limited overlap in estimation of average treatment effects," Biometrika, Biometrika Trust, vol. 96(1), pages 187-199.
    2. David Card & Carlos Dobkin & Nicole Maestas, 2004. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health Evidence from Medicare," Working Papers WR-197, RAND Corporation.
    3. Joseph G. Altonji & Todd E. Elder & Christopher R. Taber, 2005. "Selection on Observed and Unobserved Variables: Assessing the Effectiveness of Catholic Schools," Journal of Political Economy, University of Chicago Press, vol. 113(1), pages 151-184, February.
    4. Joseph J. Doyle Jr., 2005. "Health Insurance, Treatment and Outcomes: Using Auto Accidents as Health Shocks," NBER Working Papers 11099, National Bureau of Economic Research, Inc.
    5. Hitoshi Shigeoka, 2014. "The Effect of Patient Cost Sharing on Utilization, Health, and Risk Protection," American Economic Review, American Economic Association, vol. 104(7), pages 2152-2184, July.
    6. Jeffrey M Wooldridge, 2010. "Econometric Analysis of Cross Section and Panel Data," MIT Press Books, The MIT Press, edition 2, volume 1, number 0262232588, April.
    7. Charles J. Courtemanche & Daniela Zapata, 2014. "Does Universal Coverage Improve Health? The Massachusetts Experience," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 33(1), pages 36-69, January.
    8. Grossman, Michael & Mocan, Naci (ed.), 2011. "Economic Aspects of Obesity," National Bureau of Economic Research Books, University of Chicago Press, number 9780226310091.
    9. David Card & Carlos Dobkin & Nicole Maestas, 2008. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization: Evidence from Medicare," American Economic Review, American Economic Association, vol. 98(5), pages 2242-2258, December.
    10. Finkelstein, Amy & McKnight, Robin, 2008. "What did Medicare do? The initial impact of Medicare on mortality and out of pocket medical spending," Journal of Public Economics, Elsevier, vol. 92(7), pages 1644-1668, July.
    11. Dafny, Leemore & Gruber, Jonathan, 2005. "Public insurance and child hospitalizations: access and efficiency effects," Journal of Public Economics, Elsevier, vol. 89(1), pages 109-129, January.
    12. David Card & Carlos Dobkin & Nicole Maestas, 2004. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health: Evidence from Medicare," NBER Working Papers 10365, National Bureau of Economic Research, Inc.
    13. Jay Bhattacharya & M. Kate Bundorf & Noemi Pace & Neeraj Sood, 2011. "Does Health Insurance Make You Fat?," NBER Chapters, in: Economic Aspects of Obesity, pages 35-64, National Bureau of Economic Research, Inc.
    14. Heller, Ruth & Rosenbaum, Paul R. & Small, Dylan S., 2009. "Split Samples and Design Sensitivity in Observational Studies," Journal of the American Statistical Association, American Statistical Association, vol. 104(487), pages 1090-1101.
    15. Michael Grossman & Naci H. Mocan, 2011. "Economic Aspects of Obesity," NBER Books, National Bureau of Economic Research, Inc, number gros09-1.
    16. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-1296, December.
    17. Joseph J. Doyle, 2005. "Health Insurance, Treatment and Outcomes: Using Auto Accidents as Health Shocks," The Review of Economics and Statistics, MIT Press, vol. 87(2), pages 256-270, May.
    18. Weathers, Robert R. & Stegman, Michelle, 2012. "The effect of expanding access to health insurance on the health and mortality of Social Security Disability Insurance beneficiaries," Journal of Health Economics, Elsevier, vol. 31(6), pages 863-875.
    19. Sarah Miller & Laura R. Wherry, 2019. "The Long-Term Effects of Early Life Medicaid Coverage," Journal of Human Resources, University of Wisconsin Press, vol. 54(3), pages 785-824.
    20. Imbens,Guido W. & Rubin,Donald B., 2015. "Causal Inference for Statistics, Social, and Biomedical Sciences," Cambridge Books, Cambridge University Press, number 9780521885881.
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    2. Fitzpatrick, Maria D. & Moore, Timothy J., 2018. "The mortality effects of retirement: Evidence from Social Security eligibility at age 62," Journal of Public Economics, Elsevier, vol. 157(C), pages 121-137.
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    6. Arenas, Erika & Parker, Susan W. & Rubalcava, Luis & Teruel, Graciela, 2023. "Impact of health insurance on adult mortality in rural areas: Evidence of Seguro Popular in Mexico using panel data," World Development Perspectives, Elsevier, vol. 30(C).

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    More about this item

    Keywords

    health insurance; mortality;

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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