The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions

Journal of Policy Analysis and Management

Volumn 36, Issue 2, 2017, Pages 390-417

  Simon, Kosali ^a   Soni, Aparna ^b   Cawley, John ^c  

^a INDIANA UNIVERSITY   (United States)

^b INDIANA UNIVERSITY   (United States)

^c Department of Obstetrics Gynecology   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; HEALTH BEHAVIOR; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HEALTH INSURANCE; HEALTH STATUS; HIGH RISK BEHAVIOR; HUMAN; INSURANCE; MEDICAID; MIDDLE AGED; POVERTY; PREVENTIVE HEALTH SERVICE; STATISTICS AND NUMERICAL DATA; UNITED STATES; UTILIZATION;

ADULT; HEALTH BEHAVIOR; HEALTH SERVICES ACCESSIBILITY; HEALTH STATUS; HUMANS; INSURANCE COVERAGE; INSURANCE, HEALTH; MEDICAID; MIDDLE AGED; PATIENT PROTECTION AND AFFORDABLE CARE ACT; POVERTY; PREVENTIVE HEALTH SERVICES; RISK-TAKING; UNITED STATES;

EID: 85014967383     PISSN: 02768739     EISSN: 15206688     Source Type: Journal    
DOI: 10.1002/pam.21972     Document Type: Article

References (72)

1. Agency for Healthcare Research and Quality (AHRQ). (2014). Access to health care. In National Healthcare Quality Report. Rockville, MD.
2. Akee, R., Simeonova E., Copeland W., Angold A., & Costello, E. J. (2013). Young adult obesity and household income: Effects of unconditional cash transfers. American Economic Journal: Applied Economics, 5, 1–28.
3. Anderson, R. T., Camacho, F. T., & Balkrishnan, R. (2007). Willing to wait? The influence of patient wait time on satisfaction with primary care. BMC Health Services Research, 7.
4. Angrist, J. D., & Pischke, J. S. (2008). Mostly harmless econometrics: An empiricist's companion. Princeton, NJ: Princeton University Press.
5. Akosa Antwi, Y., Moriya, A. S., & Simon, K. I. (2013). Effects of federal policy to insure young adults: Evidence from the 2010 Affordable Care Act's dependent-coverage mandate. American Economic Journal: Economic Policy, 5, 1–28.
6. Aron-Dine, A., Einav, L., & Finkelstein, A. (2013). The RAND health insurance experiment, three decades later. Journal of Economic Perspectives, 27, 197–222.
7. Artiga, S., & Cornachione, E. (2016). Trends in Medicaid and CHIP eligibility over time. Kaiser Family Foundation. Retrieved April 20, 2016, from http://kff.org/report-section/trends-in-medicaid-and-chip-eligibility-over-time-section-3-eligibility-trends-by-medicaid-expansion-status-2016-update/.
8. Assistant Secretary for Planning and Evaluation (ASPE), U.S. Department of Health and Human Services (DHHS). (2015). HHS strategic plan. Retrieved April 8, 2016, from http://www.hhs.gov/about/strategic-plan/strategic-goal-1/.
9. Autor, D. H., & Houseman, S. N. (2010). Do temporary-help jobs improve labor market outcomes for low-skilled workers? Evidence from “Work First.” American Economic Journal: Applied Economics, 2, 96–128.
10. Baicker, K., Taubman, S. L., Allen, H. L., Bernstein, M., Gruber, J. H., Newhouse, J. P., … Finkelstein, A. N.; Oregon Health Study Group. (2013). The Oregon experiment—Effects of Medicaid on clinical outcomes. New England Journal of Medicine, 368, 1713–1722.
11. Barbaresco, S., Courtemanche, C. J., & Qi, Y. (2015). Impacts of the Affordable Care Act dependent coverage provision on health-related outcomes of young adults. Journal of Health Economics, 40, 54–68.
12. Bhattacharya, J., & Sood, N. (2007). Health insurance and the obesity externality. Advances in Health Economics and Health Services Research, 17, 279–318.
13. Bhattacharya, J., & Sood, N. (2011). Who pays for obesity? Journal of Economic Perspectives, 25, 139–158.
14. Brook, R. H., Ware Jr., J. E., Rogers, W. H., Keeler, E. B., Davies, A. R., Donald, C. A., … Newhouse, J. P. (1983). Does free care improve adults’ health? Results from a randomized controlled trial. New England Journal of Medicine, 309, 1426–1434.
15. Buchmueller, T., Miller, S., & Vujicic, M. (2016). How do providers respond to changes in public health insurance coverage? Evidence from Medicaid adult dental coverage. American Economic Journal, 8, 70–102.
16. Cameron, A. C., Gelbach, J. B., & Miller, D. L. (2008). Bootstrap-based improvements for inference with clustered errors. Review of Economics and Statistics, 90, 414–427.
17. Campbell, M. K., DeVellis, B. M., Strecher, V. J., Ammerman, A. S., DeVellis, R. F., & Sandler, R. S. (1994). Improving dietary behavior: The effectiveness of tailored messages in primary care settings. American Journal of Public Health, 84, 783–787.
18. Cawley, J. (2014). The Affordable Care Act permits greater financial rewards for weight loss: A good idea in principle, but many practical concerns remain. Journal of Policy Analysis and Management, 33, 810–820.
19. Cawley, J., & Ruhm, C. J. (2012). The economics of risky health behaviors. In T. G. McGuire, M. V. Pauly, & P. P. Barros (Eds.), Handbook of health economics (Vol. 2, pp. 95–199). New York: Elsevier.
20. Cawley, J., Moran, J., & Simon, K. I. (2010). The impact of income on the weight of elderly Americans. Health Economics, 19, 979–993.
21. Cawley, J., Maclean, J. C., Hammer, M., & Wintfeld, N. (2015). Reporting error in weight and its implications for estimates of the economic consequences of obesity. Economics and Human Biology, 19, 27–44.
22. Centers for Disease Control and Prevention. (2014). 2013 National Health Interview Survey (NHIS) public use data release: Survey description. Retrieved December 23, 2015, from http://www.cdc.gov/nchs/nhis/data-questionnaires-documentation.htm.
23. Centers for Disease Control and Prevention. (2016). Strategies for reducing health disparities—Selected CDC-sponsored interventions. Morbidity and Mortality Weekly Report, 65, 1–70.
24. Courtemanche, C. J., & Zapata, D. (2014). Does universal coverage improve health? The Massachusetts experience. Journal of Policy Analysis and Management, 33, 36–69.
25. Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2016). Early impacts of the Affordable Care Act on health insurance coverage in Medicaid expansion and non-expansion states. Journal of Policy Analysis and Management, 36, 178–210.
26. Damiano, P., Bentler, S. E., Momany, E. T., Park, K. H., & Robinson, E. (2013). Evaluation of the IowaCare program: Information about the medical home expansion. The University of Iowa Public Policy Center, Iowa City, IA. Accessed on January 30, 2016.
27. Dave, D., & Kaestner, R. (2009). Health insurance and ex ante moral hazard: Evidence from Medicare. International Journal of Health Care Finance and Economics, 9, 367–390.
28. De Preux, L. B. (2011). Anticipatory ex-ante moral hazard and the effect of Medicare on prevention. Health Economics, 20, 1056–1072.
29. Ehrlich, I., & Becker, G. S. (1972). Market insurance, self-insurance, and self-protection. Journal of Political Economy, 80, 623–648.
30. Epstein, A. M., & Newhouse, J. P. (1998). Impact of Medicaid expansion on early prenatal care and health outcomes. Health Care Financing Review, 19, 85–99.
31. Finkelstein, A., Taubman, S., Wright, B., Bernstein, M., Gruber, J., Newhouse, J. P., … Baicker, K; the Oregon Health Study Group. (2012). The Oregon health insurance experiment: Evidence from the first year. Quarterly Journal of Economics, 127, 1057–1106.
32. Frean, M., Gruber, J., & Sommers, B. D. (2016). Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act. NBER Working Paper No. 22213. Cambridge, MA: National Bureau of Economic Research.
33. Gates, A., & Rudowitz, R. (2014). Wisconsin's BadgerCare program and the ACA. Kaiser Family Foundation, http://kff.org/medicaid/fact-sheet/wisconsins-badgercare-program-and-the-aca/. Accessed on January 20, 2016.
34. Gooptu, A., Moriya, A. S., Simon, K. I., & Sommers, B. D. (2016). Reductions in 2014 Medicaid expansion did not result in significant employment changes. Health Affairs, 35, 111–118.
35. Heberlein, M., Brooks, T., Guyer, J., Artiga, S., & Stephens, J. (2011). Holding steady, looking ahead: Annual findings of a 50-state survey of eligibility rules, enrollment and renewal procedures, and cost-sharing practices in Medicaid and CHIP, 2010–2011. Kaiser Commission on Medicaid and the Uninsured. http://kff.org/health-reform/report/holding-steady-looking-ahead-annual-findings-of/. Accessed on February 2, 2016.
36. Jacobs, L. R., & Callaghan, T. (2013). Why states expand Medicaid: Party, resources, and history. Journal of Health Politics, Policy and Law, 38, 1023–1050.
37. Jianakoplos, N. A., & Bernasek, A. (1998). Are women more risk averse? Economic Inquiry, 36, 620–630.
38. Johnson, D. S., Parker, J. A., & Souleles, N. S. (2006). Household expenditure and the income tax rebates of 2001. American Economic Review, 96, 1589–1610.
39. Kaiser Family Foundation. (2016). Medicaid and the uninsured: Where are states today? Medicaid and CHIP eligibility levels for children and non-disabled adults. http://kff.org/medicaid/fact-sheet/where-are-states-today-medicaid-and-chip/. Accessed on January 15, 2016.
40. Kaestner, R., Garrett, B., Gangopadhyaya, A., & Fleming, C. (2015). Effects of ACA Medicaid expansions on health insurance coverage and labor supply. NBER Working Paper No. 21836. Cambridge, MA: National Bureau of Economic Research.
41. Kash, K. M., Holland, J. C., Halper, M. S., & Miller, D. G. (1992). Psychological distress and surveillance behaviors of women with a family history of breast cancer. Journal of the National Cancer Institute, 84, 24–30.
42. Kelly, I. R., & Markowitz, S. (2009). Incentives in obesity and health insurance. Inquiry, 46, 418–432.
43. Kling, J. R., Liebman, J. B., & Katz, L. F. (2007). Experimental analysis of neighborhood effects. Econometrica, 75, 83–119.
44. Lerman, C., Daly, M., Sands, C., Balshem, A., Lustbader, E., Heggan, T., … Engstrom, P. (1993). Mammography adherence and psychological distress among women at risk for breast cancer. Journal of the National Cancer Institute, 85, 1074–1080.
45. Miller, S. (2012). The impact of the Massachusetts health care reform on health care use among children. American Economic Review: Papers and Proceedings, 102, 502–507.
46. National Center for Health Statistics. (2015). Health, United States, 2014: With special feature on adults aged 55–64. Hyattsville, MD: Centers for Disease Control.
47. Newhouse, J. P., & the Insurance Experiment Group. (1993). Free for all? Lessons from the RAND health insurance experiment. Cambridge, MA: Harvard University Press.
48. Paltiel, A. D., Walensky, R. P., Schackman, B. R., Seage 3rd, G. R., Mercincavage, L. M., Weinstein, M. C., & Freedberg, K. A. (2006). Expanded HIV screening in the United States: Effect on clinical outcomes, HIV transmission, and costs. Annals of Internal Medicine, 145, 797–806.
49. Parker, J. A., Souleles, N. S., Johnson, D. S., & McClelland, R. (2013). Consumer spending and the economic stimulus payments of 2008. American Economic Review, 103, 2530–2553.
50. Ringel, J. S., Hosek S. D., Vollaard, B. A., & Mahnovski, S. (2002). The elasticity of demand for health care. A review of the literature and its application to the military health system. Santa Monica, CA: RAND Corporation.
51. Schmeiser, M. D. (2009). Expanding wallets and waistlines: The impact of family income on the BMI of women and men eligible for the earned income tax credit. Health Economics, 18, 1277–1294.
52. Shartzer, A., Long, S. K., & Anderson, N. (2015). Access to care and affordability have improved following Affordable Care Act implementation; problems remain. Health Affairs, 10, 161–168.
53. Sommers, B. D., Baicker, K., & Epstein, A. M. (2012). Mortality and access to care among adults after state Medicaid expansions. New England Journal of Medicine, 367, 1025–1034.
54. Sommers, B. D., Buchmueller, T., Decker, S. L., Carey, C., & Kronick, R. (2013). The Affordable Care Act has led to significant gains in health insurance and access to care for young adults. Health Affairs, 32, 165–174.
55. Sommers, B. D., Kenney, G. M., & Epstein, A. M. (2014). New evidence on the Affordable Care Act: Coverage impacts of early Medicaid expansions. Health Affairs, 33, 78–87.
56. Sommers, B. D., Gunja, M. Z., Finegold, K., & Musco, T. (2015). Changes in self-reported insurance coverage, access to care, and health under the Affordable Care Act. Journal of the American Medical Association, 314, 366–374.
57. Sommers, B. D., Blendon, R. J., & Orav, E. J. (2016). Both the “private option” and traditional Medicaid expansions improved access to care for low-income adults. Health Affairs, 35, 96–105.
58. Takahashi, Y., Tanaka, H., Kinjo, M., & Sakumoto, K. (2005). Sedation-free colonoscopy. Diseases of the Colon & Rectum, 48, 855–859.
59. Trust for America's Health. (2013). A Healthier America 2013: Strategies to move from sick care to health care in the next four years. Retrieved December 23, 2015, from http://www.rwjf.org/content/dam/farm/reports/reports/2013/rwjf403989.
60. U.S. Department of Health and Human Services (DHHS). (2000). Healthy people 2000: Understanding and improving health. Washington, DC: U.S. Government Printing Office.
61. U.S. Department of Health and Human Services (DHHS). (2010a). The surgeon general's vision for a healthy and fit nation. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General.
62. U.S. Department of Health and Human Services (DHHS). (2010b). Healthy people 2010: Understanding and improving health (2nd ed.). Washington, DC: U.S. Government Printing Office.
63. U.S. Department of Health and Human Services (DHHS), Office of the Surgeon General. (2011). National prevention strategy: America's plan for better health and wellness. Retrieved December 23, 2015, from http://www.surgeongeneral.gov/priorities/prevention/strategy/report.pdf.
64. U.S. Department of Health and Human Services (DHHS). (2014). The health consequences of smoking: 50 years of progress. A report of the surgeon general. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
65. U.S. Department of Health and Human Services (DHHS). (2016). Affordable Care Act rules on expanding access to preventive services for women. Retrieved April 17, 2016, from http://www.hhs.gov/healthcare/facts-and-features/fact-sheets/aca-rules-on-expanding-access-to-preventive-services-for-women/index.html.
66. U.S. Preventive Services Task Force (PSTF). (2005). Guide to community preventive services. New York: Oxford University Press.
67. U.S. Preventive Services Task Force (PSTF). (2014). The guide to clinical preventive services 2014: Recommendations of the U.S. Preventive Services Task Force. Agency for Healthcare Research and Quality, Publication Number 14-05158, pp. 2–4.
68. van der Wees, P. J., Zaslavsky, A. M., & Ayanian, J. Z. (2013). Improvements in health status after Massachusetts health care reform. Milbank Quarterly, 91, 663–689.
69. Wehby, G. L., Domingue, B. W., & Boardman, J. D. (2015). Prevention, use of health services, and genes: Implications of genetics for policy formation. Journal of Policy Analysis and Management, 34, 519–536.
70. Wherry, L., & Miller, S. (2016). Early coverage, access, utilization, and health effects associated with the Affordable Care Act Medicaid expansions: A quasi-experimental study. Annals of Internal Medicine, 164, 795–803.
71. Wolfers, J. (2006). Did unilateral divorce laws raise divorce rates? A reconciliation and new results. American Economic Review, 96, 1802–1820.
72. Zellner, A. (1962). An efficient method of estimating seemingly unrelated regressions and tests for aggregation bias. Journal of American Statistical Association, 57, 348–368.