The Impact of Insurance Expansions on the Already Insured: The Affordable Care Act and Medicare
The Impact of Insurance Expansions on the Already Insured: The Affordable Care Act and Medicare
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DOI：
10.1257/app.20190176
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发表时间：
2020-10-01
影响因子：
6.2
通讯作者：
Wherry, Laura R.
中科院分区：
文献类型：
--
作者：
Carey, Colleen M.;Miller, Sarah;Wherry, Laura R.
一些州还没有通过《平价医疗法案》（ACA）医疗补助计划的扩张，因为担心扩张可能会损害那些已经投保的人获得医疗服务和利用医疗服务的机会。我们使用一个大型的医疗保险受益人面板调查这种负面溢出效应。在许多子组和结果中，我们没有发现证据表明扩大医疗保险受益人的使用率降低，并且可以排除使用率或支出的所有变化，但变化非常小。这些结果表明，医疗补助的扩张并没有损害医疗保险人群的护理或利用。
Some states have not adopted the Affordable Care Act (ACA) Medicaid expansions due to concerns that the expansions may impair access to care and utilization for those who are already insured. We investigate such negative spillovers using a large panel of Medicare beneficiaries. Across many subgroups and outcomes, we find no evidence that the expansions reduced utilization among Medicare beneficiaries and can rule out all but very small changes in utilization or spending. These results indicate that the expansions in Medicaid did not impair access to care or utilization for the Medicare population.