Working Paper: NBER ID: w24647
Authors: Amanda E. Kowalski
Abstract: A headline result from the Oregon Health Insurance Experiment is that emergency room (ER) utilization increased. A seemingly contradictory result from the Massachusetts health reform is that ER utilization decreased. I reconcile both results by identifying treatment effect heterogeneity within the Oregon experiment and extrapolating it to Massachusetts. Even though Oregon compliers increased their ER utilization, they were adversely selected relative to Oregon never takers, who would have decreased their ER utilization. Massachusetts expanded coverage from a higher level to healthier compliers. Therefore, Massachusetts compliers are comparable to a subset of Oregon never takers, which can reconcile the results.
Keywords: compliers; late; marginal treatment effect; program evaluation; untreated outcome
JEL Codes: C00; H00; I10
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Massachusetts Health Reform (I13) | ER utilization (R19) |
| Oregon compliers (Y20) | ER utilization (R19) |
| Massachusetts compliers (C88) | ER utilization (R19) |
| Health status of compliers (I12) | ER utilization (R19) |
| Health insurance coverage (I13) | ER utilization (R19) |