The Long-Term Effect of Health Insurance on Near-Elderly Health and Mortality

Abstract

We use the best available longitudinal dataset, the Health and Retirement Survey, and a battery of causal inference methods to provide both central estimates and bounds on the effect of health insurance on health and mortality among the near elderly (initial age 50-61) over an 18-year period. Those uninsured in 1992 consume fewer healthcare services, but are not less healthy and, in our central estimates, do not die sooner than their insured counterparts. We discuss why a zero average effect of uninsurance on mortality and health is plausible, some selection effects that might explain our full results, and methodological concerns with prior studies.

The Appendix that accompanies this article is available on SSRN at http://ssrn.com/abstract=2758692.

Keywords: health insurance, Medicare, healthcare utilization

JEL Classification: H51, I12, I18, K32