Courtemanche Charles, Marton James, Ukert Benjamin, Yelowitz Aaron, Zapata Daniela
1 University of Kentucky, Lexington, USA.
2 National Bureau of Economic Research, Cambridge, MA, USA.
Inquiry. 2018 Jan-Dec;55:46958018796361. doi: 10.1177/0046958018796361.
Using data from the Behavioral Risk Factor Surveillance System, we examine the causal impact of the Affordable Care Act on health-related outcomes after 3 years. We estimate difference-in-difference-in-differences models that exploit variation in treatment intensity from 2 sources: (1) local area prereform uninsured rates from 2013 and (2) state participation in the Medicaid expansion. Including the third postreform year leads to 2 important insights. First, gains in health insurance coverage and access to care from the policy continued to increase in the third year. Second, an improvement in the probability of reporting excellent health emerged in the third year, with the effect being largely driven by the non-Medicaid expansions components of the policy.
利用行为风险因素监测系统的数据，我们考察了《平价医疗法案》实施三年后对健康相关结果的因果影响。我们估计了双重差分模型，该模型利用了两个来源的治疗强度差异：（1）2013年当地改革前未参保率；（2）各州参与医疗补助扩大计划的情况。纳入改革后的第三年带来了两个重要发现。第一，该政策带来的医疗保险覆盖范围和医疗服务可及性的改善在第三年持续增加。第二，第三年报告健康状况极佳的概率有所提高，这一效果主要由该政策中不属于医疗补助扩大计划的部分推动。
