Wettstein Gal
Department of Economics, Harvard University, Cambridge, MA, USA.
Health Econ. 2018 Mar;27(3):454-464. doi: 10.1002/hec.3585. Epub 2017 Sep 21.
Much of the debate surrounding reform of the Patient Protection and Affordable Care Act (ACA) revolves around its insurance market regulation. This paper studies the impact on health insurance coverage of those provisions. Using data from the American Community Survey, years 2008-2015, I focus on individuals, ages 26 to 64, who are ineligible for the subsidies or Medicaid expansions included in the ACA to isolate the effect of its market regulation. To account for time trends, I utilize a differences-in-differences approach with a control group of residents of Massachusetts who were already subject to a similarly regulated health insurance market. I find that the ACA's regulations caused an increase of 0.95 percentage points in health insurance coverage for my sample in 2014. This increase was concentrated among younger individuals, suggesting that the law's regulations ameliorated adverse selection in the individual health insurance market.
围绕《患者保护与平价医疗法案》(ACA)改革的诸多争论都集中在其保险市场监管方面。本文研究了这些条款对医疗保险覆盖范围的影响。利用2008 - 2015年美国社区调查的数据,我将重点放在年龄在26至64岁之间、无资格享受ACA所包含的补贴或医疗补助扩大计划的个人身上,以分离出其市场监管的效果。为了考虑时间趋势,我采用了双重差分法,对照组为马萨诸塞州那些已经处于类似监管的医疗保险市场中的居民。我发现,ACA的监管在2014年使我的样本的医疗保险覆盖率提高了0.95个百分点。这一增长集中在较年轻的人群中,表明该法律的监管改善了个人医疗保险市场中的逆向选择问题。