Department of Economics and Business, The Colin Powell School at City College of New York, The Graduate Center, City University of New York, 160 Convent Avenue, New York, 10031, USA.
Int J Health Econ Manag. 2021 Dec;21(4):495-510. doi: 10.1007/s10754-021-09306-5. Epub 2021 May 2.
Expansion of subsidized health insurance may result in both safer and riskier health behavior and outcomes. While having insurance lowers cost barriers to receive both usual and preventive care, the lower potential cost from adverse health events may also promote risky behavior. In this paper, I exploit expansion in the Medicaid program under the Affordable Care Act to estimate the impact of insurance expansion on health outcomes and behaviors for low-income individuals in the US. I find that expansion of coverage has significantly lowered cost and increased access, particularly among minority populations, but has had no significant impact on preventive health behaviors. At the same time, I also find no evidence of moral hazard or increase risky behavior like smoking and drinking among residents of expansion states.
医疗保险的扩大可能会导致更安全和更危险的健康行为和结果。虽然保险降低了接受常规和预防保健的成本障碍，但来自不良健康事件的潜在成本降低也可能促进危险行为。在本文中，我利用平价医疗法案下医疗补助计划的扩大，来估计保险范围的扩大对美国低收入人群的健康结果和行为的影响。我发现，保险范围的扩大显著降低了成本并增加了获得保险的机会，特别是在少数族裔群体中，但对预防保健行为没有显著影响。与此同时，我也没有发现道德风险的证据，也没有发现扩张州的居民有增加吸烟和饮酒等危险行为的迹象。
