Impacts of the ACA Medicaid Expansion on Health Behaviors: Evidence from Household Panel Data

37 Pages Posted: 21 Jun 2017 Last revised: 10 Jan 2019

See all articles by Chad D. Cotti

Chad D. Cotti

University of Wisconsin - Oshkosh

Erik Nesson

Ball State University - Department of Economics

Nathan Tefft

Bates College

Date Written: January 7, 2019

Abstract

A motivation for increasing health insurance coverage is to improve health outcomes for impacted populations. However, health insurance coverage may alternatively increase risky health behaviors due to ex ante moral hazard, and past research on this issue has led to mixed conclusions. This paper uses a panel of household purchases to estimate the effects of the recent state-level Medicaid expansions resulting from the Affordable Care Act (ACA) on consumption goods that present adverse health risks. We utilize within-household variation to identify whether increases in Medicaid availability impacted household purchase patterns of alcohol, nicotine-related, snack food, and carbonated beverage products. Overall, we find little evidence that the ACA Medicaid expansion led to ex ante moral hazard across any of these products, but we find compelling evidence that the Medicaid expansions reduced cigarette consumption and increased smoking cessation product use among the Medicaid-eligible population.

Keywords: Affordable Care Act, Medicaid, Moral Hazard, Risky Behaviors

JEL Classification: I13, I12

Suggested Citation

Cotti, Chad D. and Nesson, Erik and Tefft, Nathan, Impacts of the ACA Medicaid Expansion on Health Behaviors: Evidence from Household Panel Data (January 7, 2019). Available at SSRN: https://ssrn.com/abstract=2989323 or http://dx.doi.org/10.2139/ssrn.2989323

Chad D. Cotti

University of Wisconsin - Oshkosh ( email )

800 Algoma Blvd
Oshkosh, WI WI 54901
United States

Erik Nesson (Contact Author)

Ball State University - Department of Economics ( email )

Muncie, IN 47306-0340
United States

Nathan Tefft

Bates College ( email )

Lewiston, ME 04240
United States

Do you have a job opening that you would like to promote on SSRN?

Paper statistics

Downloads
136
Abstract Views
829
rank
246,593
PlumX Metrics