Effects of the Affordable Care Act Medicaid Expansion on Subjective Well-Being in the US Adult Population, 2010–2016

Kobayashi, Lindsay C.; Altındağ, Onur; Truskinovsky, Yulya; Berkman, Lisa F.

doi:10.2105/ajph.2019.305164

Cited by 14 publications

(12 citation statements)

References 25 publications

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“…This study shows that health insurance coverage plays an important role in determining individuals' SWB. The studies most closely related to our research are those by Finkelstein et al (2012), Baicker et al (2013), andKobayashi et al (2019). Finkelstein et al (2012) and Baicker et al (2013) show that gaining Medicaid coverage in Oregon via a lottery draw, known as the Oregon Health Insurance Experiment (HIE), increased the self-reported happiness of low-income individuals by 0.39 SD after the first year, but a significant difference was not detected after the second year.…”

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confidence: 63%

“…For example, in the Oregon HIE, only about 30% of the selected individuals were enrolled in Oregon's Medicaid program. Kobayashi et al (2019) estimated the SWB impact of the ACA Medicaid expansion using Gallup-Sharecare Well-being data between 2010 and 2016 but found no evidence of a positive SWB impact. The authors cannot identify policy-eligible individuals precisely because the Gallup data provide only a few household income brackets.…”

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confidence: 99%

“…3 3 To identify policy‐eligible individuals, Kobayashi et al. (2019) use the midpoints of income brackets, resulting in the potential classification errors of policy‐eligible sample respondents. This could attenuate the estimates.…”

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confidence: 99%

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Health insurance and subjective well‐being: Evidence from two healthcare reforms in the United States

Kim

Koh

2021

Health Economics

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Health insurance plays a major role in mitigating the financial losses of households due to unexpected sickness. However, health insurance coverage is generally suboptimal due to market failures such as information asymmetry. To alleviate this under-insurance problem, many governments have attempted to expand health insurance coverage. Due to the financial burden of expanding health insurance coverage, it is of great interest to both researchers and policymakers to understand the welfare impacts of gaining access to health insurance coverage.Although a direct approach to conducting such welfare analysis is through counterfactual policy simulations using structurally estimated parameters, this approach imposes strong modeling assumptions and is computationally challenging. 1 To overcome these limitations, researchers have used a reduced-form approach combined with subjective well-being (SWB) data to evaluate the welfare impacts of several public policies (Deaton, 2018;Gruber & Mullainathan, 2005;Ludwig et al., 2012;Oishi & Diener, 2014) by presuming that SWB data can proxy for an individual's (experienced) utility (Kahneman & Sugden, 2005).In this study, we attempt to provide causal evidence on the effect of health insurance coverage on SWB by analyzing large-scale healthcare reforms in the United States. Federal and state governments in the United States have implemented several reforms to expand health insurance coverage among the uninsured over the past 2 decades. Many studies have evaluated the effects of these healthcare reforms on outcomes such as health, healthcare utilization, household finances,

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confidence: 63%

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confidence: 99%

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Health insurance and subjective well‐being: Evidence from two healthcare reforms in the United States

Kim

Koh

2021

Health Economics

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“…between 2010-2016 revealed a negligible effect of the ACA on life satisfaction and no impact on emotional states. [17] By providing medical insurance, the ACA addresses one barrier to improved health outcomes for vulnerable populations, but this study of wellbeing provides objective evidence of the significant work that remains to address SDH.…”

Section: Discussionmentioning

confidence: 99%

Hospital based physician advisor program sheds new light on observation rate

Owolabi

2020

JHA

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Hospital observation is a topic of interest among patients for whom being classified as observation has negative financial ramifications. Similarly, observation rate is monitored by some hospital administrators because of its potential financial impact on the health system. During the creation of an internal physician advisor program, the new health system physician advisor was asked to investigate causes for a higher than average observation rate for WellSpan Summit Health. Using Lean methodology, standard work was established for the physician advisor observation patient review process when inpatient criteria were not met. Key performance indicators were tracked using production boards and a dashboard that interfaces with the electronic health record. The physician advisor program decreased missed inpatient conversion opportunities, but despite fixing process problems, improving level of care determination accuracy, and seeing outcomes that should have decreased the observation rate, the observation rate paradoxically increased. The cause of the rising observation rate is unknown but is likely multifactorial. Possible causes include changing standards concerning what qualifies as inpatient, Affordable Care Act (ACA) expansion of insured patients presenting to the emergency department (ED) with low acuity conditions, and the safety net function of the hospital for patients living with adverse social determinants of health. The safety net theory is most likely true for “high utilizers” using a greater portion of hospital resources than the rest of the population. This study provides evidence that observation rate is not a useful metric in the absence of a process problem. A more meaningful metric concerning observation patients is observation length of stay.

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“…Consistent with other research, these results highlight the importance of understanding more than access and service utilization when considering health care needs. For example, a study of more than 1.6 million people found no association of improved access to health care services with selfreported well-being, decreased stress, or improved life satisfaction ( Kobayashi et al, 2019 ). Care management interventions can address these factors in addition to other clinical determinants and SDoH.…”

Section: Signifi Cantly More Individuals With Readmission Versus With...mentioning

confidence: 99%

Care Management Intervention to Address Determinants of Health for Individuals With Multiple Behavioral Health Readmission

Hutchison¹,

Herschell²,

Edwards³

et al. 2022

Professional Case Management

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ocioeconomic and basic needs, as well as conditions of an individual's environment, also known as social determinants of health (SDoH), may exacerbate illness symptoms and contribute to rates of unplanned emergent care and hospitalization. Within behavioral health care, SDoH have been named as potential contributors to the "revolving door" of inpatient readmissions (Habit et al., 2018). The demand for health care systems to help facilitate linkages to community-based services and resources, support the provider network, and understand the needs of individuals is critical to making an impact on whole person health as well as population health.Likely in part of negative repercussions of coronavirus disease-2019 (COVID-19) on unemployment, rates of individuals covered under Medicaid have increased, with economic recovery expected to occur over the next 2 years or longer (Corallo & Rudowitz, 2021; Health Management Associates, 2020). Management of the increase in Medicaid enrollment is especially challenging at this time, as rates of behavioral health issues, which include mental health (MH) disorders and substance use disorders (SUDs), have increased and symptoms have

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Effects of the Affordable Care Act Medicaid Expansion on Subjective Well-Being in the US Adult Population, 2010–2016

Cited by 14 publications

References 25 publications

Health insurance and subjective well‐being: Evidence from two healthcare reforms in the United States

Health insurance and subjective well‐being: Evidence from two healthcare reforms in the United States

Hospital based physician advisor program sheds new light on observation rate

Care Management Intervention to Address Determinants of Health for Individuals With Multiple Behavioral Health Readmission

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