Impacts of the ACA Medicaid expansion on health behaviors: Evidence from household panel data
Impacts of the ACA Medicaid expansion on health behaviors: Evidence from household panel data
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DOI：
10.1002/hec.3838
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发表时间：
2019-02-01
期刊：
影响因子：
2.1
通讯作者：
Tefft, Nathan
中科院分区：
文献类型：
--
作者：
Cotti, Chad;Nesson, Erik;Tefft, Nathan
增加医疗保险覆盖面的一个动机是改善受影响人口的健康状况。然而，健康保险覆盖范围可能会增加风险的健康行为，由于事前的道德风险，过去对这个问题的研究导致了混合的结论。本文使用了一个家庭购买面板来估计最近的州一级医疗补助扩张的影响，导致负担得起的医疗法案（ACA）的消费品，目前不利的健康风险。我们利用家庭内的变化，以确定是否增加医疗补助的可用性影响家庭购买模式的酒精，尼古丁相关，零食和碳酸饮料产品。总的来说，我们几乎没有证据表明ACA医疗补助计划的扩张导致了这些产品的事前道德风险，但我们发现了令人信服的证据表明，医疗补助计划的扩张减少了卷烟消费，增加了符合医疗补助条件的人群中戒烟产品的使用。
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.