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

44 Pages Posted: 16 Jul 2012 Last revised: 8 Apr 2016

See all articles by Bernard S. Black

Bernard S. Black

Northwestern University

José-Antonio Espín-Sánchez

Yale University; Yale University - Cowles Foundation; Economic Growth Center

Eric French

Department of Economics; Institute for Fiscal Studies (IFS)

Kate Litvak

Northwestern University - Pritzker School of Law

Date Written: April 4, 2016


We use the best available longitudinal dataset, the Health and Retirement Survey, and a battery of causal inference methods to provide both central estimates and bounds on the effect of health insurance on health and mortality among the near elderly (initial age 50-61) over an 18-year period. Those uninsured in 1992 consume fewer healthcare services, but are not less healthy and, in our central estimates, do not die sooner than their insured counterparts. We discuss why a zero average effect of uninsurance on mortality and health is plausible, some selection effects that might explain our full results, and methodological concerns with prior studies.

The Appendix that accompanies this article is available on SSRN at

Keywords: health insurance, Medicare, healthcare utilization

JEL Classification: H51, I12, I18, K32

Suggested Citation

Black, Bernard S. and Espin-Sanchez, Jose-Antonio and French, Eric and Litvak, Kate, The Long-Term Effect of Health Insurance on Near-Elderly Health and Mortality (April 4, 2016). Northwestern Law & Econ Research Paper 12-09, Available at SSRN: or

Bernard S. Black (Contact Author)

Northwestern University ( email )

2001 Sheridan Road
Evanston, IL 60208
United States

Jose-Antonio Espin-Sanchez

Yale University ( email )

28 Hillhouse Ave
New Haven, CT 06520-8268
United States
2034320890 (Phone)


Yale University - Cowles Foundation

Box 208281
New Haven, CT 06520-8281
United States

Economic Growth Center ( email )

Box 208269
New Haven, CT 06520-8269
United States

HOME PAGE: http://

Eric French

Department of Economics ( email )

Gower Street
London, WC1E 6BT
United Kingdom

Institute for Fiscal Studies (IFS) ( email )

7 Ridgmount Street
London, WC1E 7AE
United Kingdom

Kate Litvak

Northwestern University - Pritzker School of Law ( email )

375 E. Chicago Ave
Chicago, IL 60611
United States

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