Does Universal Coverage Improve Health? The Massachusetts Experience

63 Pages Posted: 6 Mar 2012 Last revised: 24 May 2023

See all articles by Charles Courtemanche

Charles Courtemanche

University of North Carolina (UNC) at Greensboro - Department of Economics

Daniela Zapata

University of North Carolina (UNC) at Greensboro - Department of Economics

Date Written: March 2012

Abstract

In 2006, Massachusetts passed health care reform legislation designed to achieve nearly universal coverage through a combination of insurance market reforms, mandates, and subsidies that later served as the model for national reform. Using data from the Behavioral Risk Factor Surveillance System, we provide evidence that health care reform in Massachusetts led to better overall self-assessed health. Various robustness checks and placebo tests support a causal interpretation of the results. We also document improvements in several determinants of overall health: physical health, mental health, functional limitations, joint disorders, and body mass index. Next, we show that the effects on overall health were strongest among those with low incomes, non-whites, near-elderly adults, and women. Finally, we use the reform to instrument for health insurance and estimate a sizeable impact of coverage on health.

Suggested Citation

Courtemanche, Charles and Zapata, Daniela, Does Universal Coverage Improve Health? The Massachusetts Experience (March 2012). NBER Working Paper No. w17893, Available at SSRN: https://ssrn.com/abstract=2016729

Charles Courtemanche (Contact Author)

University of North Carolina (UNC) at Greensboro - Department of Economics ( email )

Greensboro, NC 27402-6165
United States

Daniela Zapata

University of North Carolina (UNC) at Greensboro - Department of Economics ( email )

Greensboro, NC 27402-6165
United States

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