University of Pittsburgh and IZA, United States.
University of Oxford and IZA, United Kingdom.
J Health Econ. 2020 Jul;72:102320. doi: 10.1016/j.jhealeco.2020.102320. Epub 2020 May 11.
This paper studies the effects of the 2012 Deferred Action for Childhood Arrivals (DACA) initiative on health insurance coverage, access to care, health care use, and health outcomes. We exploit a difference-in-differences setup that relies on the discontinuities in the program eligibility criteria. We find that DACA increased insurance coverage. In states that granted access to Medicaid, the increase was driven by an increase in public insurance take-up. Where public coverage was not available, DACA eligibility increased individually purchased insurance. Despite the increase in insurance coverage, we find small or non-significant increases in health care use. There is some evidence that DACA increased demand for mental health services. After 2012, DACA-eligible individuals were also more likely to report a usual place of care and less likely to delay care because of financial restrictions. Finally, we find some evidence that DACA improved self-reported health and reduced depression symptoms, indicators of stress and anxiety, and hypertension. These improvements are concentrated among individuals with income below the federal poverty level.
本文研究了 2012 年《童年入境暂缓遣返》（DACA）计划对医疗保险覆盖范围、获得医疗服务的机会、医疗保健利用和健康结果的影响。我们利用差异中的差异设置，该设置依赖于计划资格标准的不连续性。我们发现 DACA 增加了保险覆盖范围。在授予医疗补助（Medicaid）资格的州，这一增长是由于公共保险的参保率增加所致。在没有公共保险的情况下，DACA 资格增加了个人购买的保险。尽管保险范围有所增加，但我们发现医疗保健利用的增加很小或没有显著增加。有一些证据表明，DACA 增加了对心理健康服务的需求。2012 年后，符合 DACA 条件的个人也更有可能报告有常规医疗服务提供者，并且因经济限制而延迟医疗服务的可能性更小。最后，我们发现有证据表明 DACA 改善了自我报告的健康状况，减少了抑郁症状、压力和焦虑的指标以及高血压。这些改善主要集中在收入低于联邦贫困线的个人中。
