The Impact of the ACA on Insurance Coverage Disparities After Four Years

34 Pages Posted: 16 Sep 2019

See all articles by Charles Courtemanche

Charles Courtemanche

University of Kentucky

Ishtiaque Fazlul

Georgia State University - Department of Economics

James Marton

Georgia State University - Andrew Young School - Department of Economics

Benjamin Ukert

University of Pennsylvania

Aaron Yelowitz

University of Kentucky - Department of Economics

Daniela Zapata

IMPAQ International LLC

Multiple version iconThere are 2 versions of this paper

Date Written: August 1, 2019

Abstract

The purpose of this chapter is to estimate the impact of the major components of the ACA (Medicaid expansion, subsidized Marketplace plans, and insurance market reforms) on disparities in insurance coverage after four years. We use data from the 2011–2017 waves of the American Community Survey (ACS), with the sample restricted to nonelderly adults. Our methods feature a difference-in-difference-in-differences model, developed in the recent ACA literature, which separately identifies the effects of the nationwide and Medicaid expansion portions of the law. The differences in this model come from time, state Medicaid expansion status, and local area pre-ACA uninsured rate. We stratify our sample separately by income, race/ethnicity, marital status, age, gender, and geography in order to examine access disparities. After four years, we find that the fully implemented ACA eliminated 44 percent of the coverage gap across income groups, with the Medicaid expansion accounting for this entire reduction. The ACA also reduced coverage disparities across racial groups by 26.7 percent, across marital status by 45 percent, and across age groups by 44 percent, with these changes being partly attributable to both the Medicaid expansion and nationwide components of the law.

Keywords: Medicaid, Affordable Care Act, Health Care Finance, Disparities in Insurance Coverage

Suggested Citation

Courtemanche, Charles and Fazlul, Ishtiaque and Marton, James and Ukert, Benjamin and Yelowitz, Aaron and Zapata, Daniela, The Impact of the ACA on Insurance Coverage Disparities After Four Years (August 1, 2019). Andrew Young School of Policy Studies Research Paper Series No. 19-09, Available at SSRN: https://ssrn.com/abstract=3453472 or http://dx.doi.org/10.2139/ssrn.3453472

Charles Courtemanche

University of Kentucky ( email )

Ishtiaque Fazlul

Georgia State University - Department of Economics ( email )

P.O. Box 3992
Atlanta, GA 30302-3992
United States

James Marton (Contact Author)

Georgia State University - Andrew Young School - Department of Economics ( email )

P.O. Box 3992
Atlanta, GA 30302-3992
United States

Benjamin Ukert

University of Pennsylvania ( email )

Philadelphia, PA 19104
United States

Aaron Yelowitz

University of Kentucky - Department of Economics ( email )

Lexington, KY 40506
United States

Daniela Zapata

IMPAQ International LLC ( email )

1325 G Street, NW
Suite 900
Washington, DC 20005
United States

Do you have negative results from your research you’d like to share?

Paper statistics

Downloads
71
Abstract Views
599
Rank
531,415
PlumX Metrics