Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health

74 Pages Posted: 25 Apr 2017

See all articles by Charles Courtemanche

Charles Courtemanche

Georgia State University - Andrew Young School of Policy Studies

James Marton

Georgia State University - Andrew Young School - Department of Economics

Benjamin Ukert

University of Pennsylvania

Aaron Yelowitz

University of Kentucky - Department of Economics

Daniela Zapata

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

Date Written: March 1, 2017

Abstract

The goal of the Affordable Care Act (ACA) was to achieve nearly universal health insurance coverage through a combination of mandates, subsidies, marketplaces, and Medicaid expansions, most of which took effect in 2014. We use data from the Behavioral Risk Factor Surveillance System to examine the impacts of the ACA on health care access, risky health behaviors, and self-assessed health after two years. We estimate difference-in-difference-in-differences models that exploit variation in treatment intensity from state participation in the Medicaid expansion and pre-ACA uninsured rates. Results suggest that the ACA led to sizeable improvements in access to health care in both Medicaid expansion and non-expansion states, with the gains being larger in expansion states along some dimensions. No statistically significant effects on risky behaviors or self-assessed health emerge for the full sample. However, we find some evidence that the ACA improved self-assessed health among older non-elderly adults, particularly in expansion states.

Keywords: Affordable Care Act, Health Insurance, Medicaid, Health, Obesity, Smoking, Drinking

JEL Classification: I12, I13, I18

Suggested Citation

Courtemanche, Charles and Marton, James and Ukert, Benjamin and Yelowitz, Aaron and Zapata, Daniela, Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health (March 1, 2017). Andrew Young School of Policy Studies Research Paper Series No. 17-03. Available at SSRN: https://ssrn.com/abstract=2957708 or http://dx.doi.org/10.2139/ssrn.2957708

Charles Courtemanche

Georgia State University - Andrew Young School of Policy Studies ( email )

P.O. Box 3992
Atlanta, GA 30302-3992
United States
404-413-0082 (Phone)

James Marton

Georgia State University - Andrew Young School - Department of Economics ( email )

P.O. Box 3992
Atlanta, GA 30302-3992
United States

Benjamin Ukert (Contact Author)

University of Pennsylvania ( email )

Philadelphia, PA 19104
United States

Aaron Yelowitz

University of Kentucky - Department of Economics ( email )

Lexington, KY 40506
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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