The effect of expanding access to health insurance on the health and mortality of Social Security Disability Insurance beneficiaries

Simulated Power Analyses for Observational Studies: An Application to the Affordable Care Act Medicaid Expansion

“…In addition to the RAND Experiment, two other randomized experiments deserve attention. Weathers and Stegman (2012) find no significant mortality effect for adults receiving Social Security Disability Insurance when they receive health insurance immediately rather than after the usual 2-year waiting period, even when given assistance in navigating the health insurance system (point estimate for odds ratio 1.28, 95% CI [0.71,1.85]. However, their sample of 2,000 persons is small, and thus confidence bounds are wide.…”

Health Insurance and Health

“…Similarly, using union membership, immigrant status, and involuntary job loss as instruments for insurance, Hadley and Waidmann (2006) concluded that extending insurance coverage to all Americans between the ages of 55 and 64 would reduce mortality in this age group. Weathers and Stegman (2012) is the only study to find no effect of insurance coverage on mortality; their brief follow-up of 3 years did not allow for identification of longer term effects in their experimental data. And, HIV patients with public health insurance had a 66% lower relative risk of mortality than HIV patients without insurance.…”

“…For example, although the RAND Corporation experiment did not find an effect of insurance generosity on the health status of the average adult, insurance generosity did have a positive effect on health for individuals with high blood pressure (Keeler et al, 1985). More generally, Weathers and Stegman (2012) attributed the larger effect of health insurance in the AB demonstration as compared with the Oregon lottery to the relatively poorer health and disability status of persons in the former cases. More generally, Weathers and Stegman (2012) attributed the larger effect of health insurance in the AB demonstration as compared with the Oregon lottery to the relatively poorer health and disability status of persons in the former cases.…”

“…The AB demonstration thus provided a unique opportunity to test whether having insurance improves short-term health outcomes (Weathers and Stegman, 2012). Accordingly, between October 2007 and November 2008, a subset of newly enrolled SSDI beneficiaries was asked to participate in the Accelerated Benefits (AB) demonstration.…”

The Impact of Rehabilitation and Counseling Services on the Labor Market Activity of Social Security Disability Insurance (SSDI) Beneficiaries

“…The AB plus and AB groups experienced a 22 percentage point (46 percent) increase in the receipt of a diagnostic test and an 18 percentage point (25 percent) reduction in the report of any unmet medical need (Michalopoulos et al., ). Both groups also experienced a 10 percentage point (nearly 30 percent) reduction in the report of poor health, a 9 percentage point (14 percent) reduction in SF‐36 mental health scores indicative of depression, and a 7 percentage point (13 percent) reduction in SF‐36 scores indicative of an SSDI disability (Weathers & Stegman, ) . We attribute these findings to the health insurance package that both the AB plus and AB groups received as part of the project.…”