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The Affordable Care Act and Ambulance Response Times

Author

Listed:
  • Courtemanche, Charles

    (University of Kentucky)

  • Friedson, Andrew I.

    (University of Colorado Denver)

  • Koller, Andrew P.

    (University of Colorado Denver)

  • Rees, Daniel I.

    (Universidad Carlos III de Madrid)

Abstract

This study contributes to the literature on supply-side adjustments to insurance expansions by examining the effect of the Affordable Care Act (ACA) on ambulance response times. Exploiting temporal and geographic variation in the implementation of the ACA as well as pre-treatment differences in uninsured rates, we estimate that the expansions of private and Medicaid coverage under the ACA combined to slow ambulance response times by an average of 19%. We conclude that, through extending coverage to individuals who, in its absence, would not have availed themselves of emergency medical services, the ACA added strain to emergency response systems.

Suggested Citation

  • Courtemanche, Charles & Friedson, Andrew I. & Koller, Andrew P. & Rees, Daniel I., 2017. "The Affordable Care Act and Ambulance Response Times," IZA Discussion Papers 10951, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp10951
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    Cited by:

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    2. Chaudhary, Sookti & Davis, Alison & Troske, Kenneth & Troske, SuZanne, 2019. "Hospital Closures and Short-Run Change in Ambulance Call Times," IZA Discussion Papers 12797, Institute of Labor Economics (IZA).
    3. Nicole Black & Anthony Harris & David W. Johnston & Trong-Anh Trinh, 2024. "Workforce Impacts of Subsidised Mental Healthcare: Evidence on Supply, Earnings, and Geographic Distribution," Papers 2024-17, Centre for Health Economics, Monash University.
    4. Michael DiNardi, 2021. "Affordable Care Act Medicaid expansions and the nurse labor market," Southern Economic Journal, John Wiley & Sons, vol. 88(1), pages 367-398, July.
    5. Louis‐Philippe Beland & Jason Huh & Dongwoo Kim, 2021. "The effect of Affordable Care Act Medicaid expansions on foster care admissions," Health Economics, John Wiley & Sons, Ltd., vol. 30(11), pages 2943-2951, November.
    6. Leon Moskatel & David Slusky, 2019. "Did UberX reduce ambulance volume?," Health Economics, John Wiley & Sons, Ltd., vol. 28(7), pages 817-829, July.
    7. Dunn, Abe & Knepper, Matthew & Dauda, Seidu, 2021. "Insurance expansions and hospital utilization: Relabeling and reabling?," Journal of Health Economics, Elsevier, vol. 78(C).
    8. Jingshu Luo & Hua Chen & Martin Grace, 2022. "Medicaid expansion, tort reforms, and medical liability costs," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 89(3), pages 789-821, September.
    9. Argys, Laura M. & Friedson, Andrew I. & Pitts, M. Melinda & Tello-Trillo, D. Sebastian, 2020. "Losing public health insurance: TennCare reform and personal financial distress," Journal of Public Economics, Elsevier, vol. 187(C).
    10. Elena Lucchese, 2020. "It could be worse...it could be raining: Ambulance response time and health outcomes," Working Papers 429, University of Milano-Bicocca, Department of Economics, revised Feb 2020.
    11. Christal Hamilton, 2024. "The impact of the 2014 Medicaid expansion on the health, health care access, and financial well‐being of low‐income young adults," Health Economics, John Wiley & Sons, Ltd., vol. 33(8), pages 1895-1925, August.
    12. Charles Courtemanche & Andrew Friedson & Daniel I. Rees, 2018. "Ambulance Utilization in New York City after the Implementation of the Affordable Care Act," NBER Working Papers 24480, National Bureau of Economic Research, Inc.
    13. Dillender, Marcus & Friedson, Andrew & Gian, Cong & Simon, Kosali, 2019. "Does the healthcare educational market respond to short-run local demand?," Economics of Education Review, Elsevier, vol. 73(C).
    14. Elena Lucchese, 2024. "How important are delays in treatment for health outcomes? The case of ambulance response time and cardiovascular events," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 652-673, April.
    15. Hector Galindo-Silva & Nibene Habib Some & Guy Tchuente, 2018. "Fuzzy Difference-in-Discontinuities: Identification Theory and Application to the Affordable Care Act," Papers 1812.06537, arXiv.org, revised Apr 2021.
    16. Louis-Philippe Beland & Jason Huh & Dongwoo Kim, 2021. "The Effect of ACA Medicaid Expansions on Foster Care Admissions," Carleton Economic Papers 21-07, Carleton University, Department of Economics.
    17. 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).
    18. Bjoerkheim, Markus & Sigaud, Liam & Ampaabeng, Kofi, 2023. "The Effect of the Affordable Care Act's Medicaid Expansion on the Mental Health Of Already-Enrolled Medicaid Beneficiaries," Working Papers 12430, George Mason University, Mercatus Center.
    19. Laura Argys & Andrew Friedson & M. Melinda Pitts & D. Sebastian Tello-Trillo, 2017. "Losing Public Health Insurance: TennCare Disenrollment and Personal Financial Distress," FRB Atlanta Working Paper 2017-6, Federal Reserve Bank of Atlanta.

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    More about this item

    Keywords

    health care capacity; health insurance; ambulance; Affordable Care Act; health care workforce;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • 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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