Working Paper: NBER ID: w23450
Authors: Johanna Catherine Maclean; Michael F. Pesko; Steven C. Hill
Abstract: We explore the effects of recent Medicaid expansions on Medicaid-financed prescriptions for evidence-based smoking cessation medications. We estimate differences-in-differences models using administrative data on the universe of prescription medications sold in retail and online pharmacies for which Medicaid was a third-party payer. Our findings suggest that expansions increased smoking cessation prescriptions by 36% with heterogeneity across medication class. We provide evidence that these prescriptions were primarily financed by Medicaid programs and not patients, and that our estimates reflect increases in prescriptions among newly eligible populations and not other populations that enrolled in Medicaid due to Affordable Care Act-related changes. Overall our findings suggest that the recent Medicaid expansions allowed newly insured low-income smokers to access efficacious cessation medications.
Keywords: Medicaid; Smoking Cessation; Insurance Expansion; ACA
JEL Codes: I1; I13; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Medicaid expansions under the ACA (I18) | increase in smoking cessation medication prescriptions (I12) |
| newly eligible populations accessing Medicaid-financed prescriptions (I18) | increase in smoking cessation medication prescriptions (I12) |
| reducing out-of-pocket costs for medications (H51) | increase in utilization of smoking cessation medications (I12) |
| increase in prescriptions (I11) | predominantly financed by Medicaid programs (I18) |
| Medicaid expansion (I18) | increased access to smoking cessation aids (I12) |