Working Paper: NBER ID: w24511
Authors: Charles Courtemanche; James Marton; Benjamin Ukert; Aaron Yelowitz; Daniela Zapata
Abstract: This paper examines the impacts of the Affordable Care Act (ACA) – which substantially increased insurance coverage through regulations, mandates, subsidies, and Medicaid expansions – on behaviors related to future health risks after three years. Using data from the Behavioral Risk Factor Surveillance System and an identification strategy that leverages variation in pre-ACA uninsured rates and state Medicaid expansion decisions, we show that the ACA increased preventive care utilization along several dimensions, but also increased risky drinking. These results are driven by the private portions of the law, as opposed to the Medicaid expansion. We also conduct subsample analyses by income and age.
Keywords: Affordable Care Act; health behaviors; preventive care; risky drinking
JEL Codes: I12; I13; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| ACA (G52) | preventive care utilization (I11) |
| ACA (G52) | risky drinking (I12) |
| ACA (private portions) (G52) | risky drinking (I12) |
| ACA (G52) | increased smoking (I12) |
| ACA (G52) | decreased exercise (I12) |