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Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non‐Expansion States

Bibliographic Data

ID11684658
AuthorsCharles Courtemanche (0000-0001-5422-5350, Georgia State University, corresponding author), James Marton (0000-0002-1875-8157, Georgia State University), Benjamin Ukert (0000-0002-2337-9573, University of Pennsylvania), Aaron Yelowitz (0000-0001-8847-1437, University of Kentucky), Daniela Zapata (0000-0001-6645-664X, Impaq International (United States))
Year2016
Volume36
Issue1
Pages178-210
Publication date2016-11-07
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Policy Analysis and Management (JOURNAL)
Journal identifiersISSN: 0276-8739 • E-ISSN: 1520-6688
PublisherWiley (PUBLISHER • GB)
DOI10.1002/pam.21961
PMID27992151
OpenAlexW2342442624
LanguageEN
Citations received89
References cited45

The Affordable Care Act (ACA) aimed to achieve nearly universal health insurance coverage in the United States through a combination of insurance market reforms, mandates, subsidies, health insurance exchanges, and Medicaid expansions, most of which took effect in 2014. This paper estimates the causal effects of the ACA on health insurance coverage in 2014 using data from the American Community Survey. We utilize difference-in-difference-in-differences models that exploit cross-sectional variation in the intensity of treatment arising from state participation in the Medicaid expansion and local area pre-ACA uninsured rates. This strategy allows us to identify the effects of the ACA in both Medicaid expansion and non-expansion states. Our preferred specification suggests that, at the average pre-treatment uninsured rate, the full ACA increased the proportion of residents with insurance by 5.9 percentage points compared to 2.8 percentage points in states that did not expand Medicaid. Private insurance expansions from the ACA were due to increases in both employer-provided and non-group coverage. The coverage gains from the full ACA were largest for those without a college degree, non-whites, young adults, unmarried individuals, and those without children in the home. We find no evidence that the Medicaid expansion crowded out private coverage

Actuarial science · American Community Survey · Business · Demographic economics · Economic growth · Economics · Environmental health · Health care · Health insurance · Medicaid · Patient Protection and Affordable Care Act · Population · Private insurance · Subsidy · Demography · Global Health Care Issues · Healthcare Policy and Management · Medicine · Primary Care and Health Outcomes

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Unique citing works89
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Citation span2015 - 2026 (12)
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