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The effects of public health insurance on health behaviors: Evidence from the fifth year of Medicaid expansion

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  • Aparna Soni

Abstract

This study examines the longer term relationship between public health insurance expansions and health behaviors. I leverage geographic and temporal variation in the implementation of the Affordable Care Act‐facilitated Medicaid expansions and provide the first estimates of the expansions' behavioral impacts during their first 5 years. Using national survey data from the 2010 to 2018 Behavioral Risk Factors Surveillance System and a difference‐in‐differences regression design, I show that the Medicaid expansions increase utilization of certain forms of preventive care, while reducing heavy drinking. I also find suggestive evidence that the expansions reduce smoking and increase the probability of exercise. These results stand in contrast with earlier studies that used only 2 or 3 years of postexpansion data and found no detectable effect of the Medicaid expansions on health behaviors in the short run. My results, combined with evidence from previous studies, suggest that public insurance expansions may not prompt an immediate change in health behaviors, but newly eligible populations do increase investments in healthy behaviors over time. In the long run, Medicaid expansions may help reduce engagement in risky behaviors like drinking and smoking among low‐income people.

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  • Aparna Soni, 2020. "The effects of public health insurance on health behaviors: Evidence from the fifth year of Medicaid expansion," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1586-1605, December.
    • Handle: RePEc:wly:hlthec:v:29:y:2020:i:12:p:1586-1605
    DOI: 10.1002/hec.4155
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    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 7th December 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-12-07 12:00:03

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    2. Jihee Song & Jeong Nam Kim & Scott Tomar & Lauren N. Wong, 2021. "The Impact of the Affordable Care Act on Dental Care: An Integrative Literature Review," IJERPH, MDPI, vol. 18(15), pages 1-21, July.
    3. Chenhao Yu & Huigang Liang & Zhiruo Zhang, 2022. "Does Health Insurance Reduce the Alcohol Consumption? Evidence from China Health and Nutrition Survey," Sustainability, MDPI, vol. 14(9), pages 1-10, May.
    4. Christal Hamilton, 2024. "The impact of the 2014 Medicaid expansion on the health, health care access, and financial well‐being of low‐income young adults," Health Economics, John Wiley & Sons, Ltd., vol. 33(8), pages 1895-1925, August.
    5. Prabal K. De, 2021. "Impacts of insurance expansion on health cost, health access, and health behaviors: evidence from the medicaid expansion in the US," International Journal of Health Economics and Management, Springer, vol. 21(4), pages 495-510, December.
    6. Aimee Chabot & Maximilian Hell, 2023. "Using Technology and Iterative Research to Strengthen the Social Safety Net," The ANNALS of the American Academy of Political and Social Science, , vol. 706(1), pages 256-275, March.

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