Doucette Mitchell L, Hemraj Dipak, Fisher Emily, Macfarlan D Luke
Health Economics and Outcomes Research Division, Leafwell, Miami, FL, USA.
Appl Health Econ Health Policy. 2025 Jan;23(1):119-129. doi: 10.1007/s40258-024-00913-0. Epub 2024 Sep 17.
Recent studies suggest that medical cannabis laws may contribute to a relative reduction in health insurance costs within the individual health insurance markets at the state level. We investigated the effects of adopting a medical cannabis law on the cost of employer-sponsored health insurance in the United States.
We analyzed state-level data from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) Private Sector spanning from 2003 to 2022. The outcomes included log-transformed average total premium costs per employee for single, employee-plus-one, and family coverage plans. We utilized the Sun and Abraham (J Econometr 225(2):175-199, 2021) difference-in-difference (DiD) method, looking at the overall DiD and event-study DiD. Models were adjusted for various state-level demographics and dichotomous policy variables, including whether a state later adopted recreational cannabis, as well as time and unit fixed effects and population weights.
For states that adopted a medical cannabis law, there was a significant decrease in the log average total premium per employee for single (-0.034, standard error [SE] 0.009 (-$238)) and employee-plus-one (-0.025, SE 0.009 (-$348)) coverage plans per year considering the first 10 years of policy change compared with states without such laws. Looking at the last 5 years of policy change, we saw increases in effect size and statistical significance. In-time placebo testing suggested model robustness. Under a hypothetical scenario where all 50 states adopted medical cannabis in 2022, we estimated that employers and employees could collectively save billions on healthcare coverage, potentially reducing healthcare expenditure's contribution to GDP by 0.65% in 2022.
Adoption of a medical cannabis law may contribute to decreases in healthcare costs. This phenomenon is likely a secondary effect and suggests positive externalities outside of medical cannabis patients.
近期研究表明，医用大麻法律可能有助于在州一级的个人健康保险市场中相对降低医疗保险成本。我们调查了在美国采用医用大麻法律对雇主赞助的健康保险成本的影响。
我们分析了2003年至2022年期间医疗支出面板调查保险部分（MEPS-IC）私营部门的州级数据。结果包括单人、员工加一人以及家庭保险计划中每位员工的对数转换后的平均总保费成本。我们采用了Sun和Abraham（《计量经济学杂志》225(2):175 - 199, 2021）提出的双重差分（DiD）方法，研究总体双重差分和事件研究双重差分。模型针对各种州级人口统计数据和二分政策变量进行了调整，包括一个州后来是否采用了休闲大麻法律，以及时间和单位固定效应以及人口权重。
对于采用了医用大麻法律的州，与没有此类法律的州相比，在考虑政策变化的前10年中，单人保险计划（-0.034，标准误差[SE] 0.009（-238美元））和员工加一人保险计划（-0.025，SE 0.009（-348美元））的每位员工对数平均总保费每年都有显著下降。在政策变化的最后5年中，我们看到效应大小和统计显著性都有所增加。同期安慰剂检验表明模型具有稳健性。在一个假设情景中，即所有50个州在2022年都采用了医用大麻法律，我们估计雇主和员工在医疗保健覆盖方面总共可以节省数十亿美元，这可能会使2022年医疗保健支出对国内生产总值的贡献降低0.65%。
采用医用大麻法律可能有助于降低医疗保健成本。这种现象可能是一种次要效应，并表明在医用大麻患者之外存在积极的外部性。
