Does state repeal of alcohol exclusion laws increase problem drinking?

Abstract

Background For decades, alcohol exclusion laws (AELs) have allowed insurance companies to reject claims for physical injuries caused by alcohol consumption, including injuries from impaired driving. A central premise of AELs is that they function as a deterrent to risk‐taking behaviors, such as excessive drinking. If this assumption is correct, state repeal of these laws should result in increased drinking. This study examines whether the repeal of AELs by some states affects drinking behaviors. Methods Data were obtained from the 1993 to 2017 Behavioral Risk Factor Surveillance System nationwide survey. Exploiting the natural experiment presented by state repeal of AELs, we assessed the impact on current drinking and binge drinking. We used a rigorous quasi‐experimental difference‐in‐differences analysis and conducted a battery of sensitivity analyses to assure robust findings. Results Overall, the study found no discernable impact of state repeal of AELs on alcohol consumption. While the repeal of AELs significantly decreased the odds of reporting drinking in the past 30 days compared to those living in states with AELs or that never had AELs, the effects were small (aOR = 0.98, 95% CI = 0.96, 0.99). Likewise, there were higher odds of binge drinking among individuals living in states that repealed AELs compared to those living in states without AELs, yet with small effects (aOR = 1.03, 95% CI = 1.01, 1.05). After additionally adjusting for state‐varying characteristics and state‐specific time trends, no significant effects were identified regarding current and binge drinking. Findings from the sensitivity analyses were largely consistent with the main analysis. Conclusion This study found no evidence supporting the idea that repealing AELs increased alcohol consumption or binge drinking. Future studies should consider other state‐specific dimensions within the Uniform Accident and Sickness Policy Provision Law.

Treatment Referrals Post-prohibition of Alcohol Exclusion Laws: Evidence from Colorado and Illinois

“…One prior study found that repealing these laws had no identifiable adverse effect on drinking behaviors. 34 Another study found that AEL repeals increased alcohol treatment admissions from healthcare professional referrals, indicating a positive effect on access to care. 22 Yet, not all states that have repealed their AELs have done so in the same way.…”

Health claims denial for alcohol intoxication: State laws and structural stigma

“…NAIC's impetus for endorsing the state adoption of this provision originally appeared to be twofold. First, if the insured public knew that potential injuries were not covered if they were intoxicated by alcohol at the time of injury, then this knowledge would discourage their drinking in the first place, at least in theory (Azagba, Shan, Ebling, et al, 2022). Second, if intoxicated individuals had to assume responsibility for injury and health insurers were not liable for any losses, then these companies would ultimately save money (Cochran, 2010).…”