| 来源类型 | Working Paper
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| 规范类型 | 报告
|
| DOI | 10.3386/w20597
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| 来源ID | Working Paper 20597
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| The Early Impact of the Affordable Care Act State-By-State |
| Amanda E. Kowalski
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| 发表日期 | 2014-10-20
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| 出版年 | 2014
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| 语种 | 英语
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| 摘要 | I examine the impact of state policy decisions on the early impact of the ACA using data through the first half of 2014. I focus on the individual health insurance market, which includes plans purchased through exchanges as well as plans purchased directly from insurers. In this market, at least 13.2 million people were covered in the second quarter of 2014, representing an increase of at least 4.2 million beyond pre-ACA state-level trends. I use data on coverage, premiums, and costs and a model developed by Hackmann, Kolstad, and Kowalski (2013) to calculate changes in selection and markups, which allow me to estimate the welfare impact of the ACA on participants in the individual health insurance market in each state. I then focus on comparisons across groups of states. The estimates from my model imply that market participants in the five "direct enforcement" states that ceded all enforcement of the ACA to the federal government are experiencing welfare losses of approximately $245 per participant on an annualized basis, relative to participants in all other states. They also imply that the impact of setting up a state exchange depends meaningfully on how well it functions. Market participants in the six states that had severe exchange glitches are experiencing welfare losses of approximately $750 per participant on an annualized basis, relative to participants in other states with their own exchanges. Although the national impact of the ACA is likely to change over the course of 2014 as coverage, costs, and premiums evolve, I expect that the differential impacts that we observe across states will persist through the rest of 2014. |
| 主题 | Subnational Fiscal Issues
; Health, Education, and Welfare
; Health
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| URL | https://www.nber.org/papers/w20597
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| 来源智库 | National Bureau of Economic Research (United States)
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| 引用统计 |
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| 资源类型 | 智库出版物
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| 条目标识符 | http://119.78.100.153/handle/2XGU8XDN/578271
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推荐引用方式
GB/T 7714 |
Amanda E. Kowalski. The Early Impact of the Affordable Care Act State-By-State. 2014.
|
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