A Reevaluation of the Effects of State and ACA Dependent Coverage Mandates on Health Insurance Coverage

Barkowski, Scott; McLaughlin, Joanne Song; Ray, Alex

doi:10.1002/pam.22220

Cited by 5 publications

(1 citation statement)

References 39 publications

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“…Prior research using a variety of methods indicates that there are substantial effects of insurance coverage on utilization of medical care (Anderson et al., 2012; Aron‐Dine et al., 2013; Barkowski et al., 2020; Card et al., 2008; Gruber & Sommers, 2019; Newhouse & the Insurance Experiment Group, 1993); self‐reported health and depression (Finkelstein et al., 2012); reductions in mortality (Card et al., 2009); and consumption via reductions in out‐of‐pocket spending (Baicker et al., 2013; Barcellos & Jacobson, 2015; Engelhardt & Gruber, 2011; Finkelstein & McKnight, 2008; Finkelstein et al., 2012). The literature also documents large effects on outside parties, such as medical care providers, who often treat the uninsured without compensation (Barkowski et al., 2020; Finkelstein, Hendren, & Shepard, 2019; Gruber & Sommers, 2019; Mahoney, 2015).…”

Section: Introductionmentioning

confidence: 99%

Insurance Subsidies, the Affordable Care Act, and Financial Stability

Dodini¹

2022

J Policy Anal Manage

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This paper measures the effects of subsidies in the Affordable Care Act on adverse financial outcomes using administrative tax data and credit data on financial outcomes. Using a difference-in-differences design with propensity score reweighting, I find that at $100 per capita, ACA premium tax credits and cost-sharing reduction subsidies reduced consumer bankruptcies and severe auto delinquency by 8 percent and 7 percent, respectively, and substantially reduced right-tail delinquent debt and third-party collections. The value of recipients' risk protection against medical debt payments amounts to approximately 16 to 21 percent of the cash costs of the subsidies, while the subsidies provided substantial indirect transfers to external parties.

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Section: Introductionmentioning

confidence: 99%

Insurance Subsidies, the Affordable Care Act, and Financial Stability

Dodini¹

2022

J Policy Anal Manage

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Pandemic‐era changes to medicaid enrollment and funding: Implications for future policy and research

Dague,

Ukert

2023

J Policy Anal Manage

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The COVID‐19 public health emergency led to federal legislation that changed the landscape of Medicaid coverage for low‐income people in the United States. Policy responses led to a surge in Medicaid caseloads due to new rules preventing Medicaid disenrollment, and total Medicaid enrollment increased more from 2020 to 2023 than the net increase in insurance coverage from 2013 to 2017 following the Affordable Care Act's implementation. It is crucial for scholars and practitioners to understand the implications of this continuous coverage policy and its 2023–2024 unwinding. This paper provides an overview of Medicaid enrollment, renewal, and funding policies, highlighting how policy changed during and immediately following the acute phase of the pandemic; describes enrollment increases and their composition; reviews relevant literature; and identifies key areas for research. By examining this unprecedented period in Medicaid, we can inform future policy decisions and optimize safety net programs to be effective under a broad set of circumstances.

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Did the affordable care act increase the availability of employer‐sponsored health insurance?

Lennon

2021

Southern Economic Journal

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The 2010 Affordable Care Act (ACA) included two provisions, the Employer Shared Responsibility Provision (the “employer mandate”) and the Small Business Health Options Program (“SHOP”), aimed at increasing the availability of employer‐sponsored health insurance (ESI) among workers at small firms. To examine whether these provisions led to greater ESI availability, I use 2011–2017 Medical Expenditure Panel Survey (MEPS) data in a difference‐in‐difference framework that compares changes in ESI availability among workers at small and large firms before and after the ACA's provisions come into effect. My estimates show that there is a 3.5 percentage point increase in ESI availability among workers at smaller firms after 2013. When focusing on workers most likely to be affected by the employer mandate, I find a larger 5.2 percentage point increase in ESI availability, amounting to a 39% decline in the proportion who do not have ESI available. However, I find no evidence that greater ESI availability led to increases in ESI coverage rates. Instead, descriptive estimates suggest that gains in health insurance coverage after 2013 consist of significant increases in the number of working adults who report having Medicaid coverage, including among workers who are offered ESI. I use MEPS data for my analysis because, along with employment, firm size, and health insurance details, MEPS also provides health status and healthcare access/utilization information. Looking at changes in these health measures, I find only limited evidence to suggest that the ACA's provisions improved access to care or measures of health status for workers.

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A Reevaluation of the Effects of State and ACA Dependent Coverage Mandates on Health Insurance Coverage

Cited by 5 publications

References 39 publications

Insurance Subsidies, the Affordable Care Act, and Financial Stability

Insurance Subsidies, the Affordable Care Act, and Financial Stability

Pandemic‐era changes to medicaid enrollment and funding: Implications for future policy and research

Did the affordable care act increase the availability of employer‐sponsored health insurance?

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