Health insurance and subjective well‐being: Evidence from two healthcare reforms in the United States

Abstract

Health insurance plays a major role in mitigating the financial losses of households due to unexpected sickness. However, health insurance coverage is generally suboptimal due to market failures such as information asymmetry. To alleviate this under-insurance problem, many governments have attempted to expand health insurance coverage. Due to the financial burden of expanding health insurance coverage, it is of great interest to both researchers and policymakers to understand the welfare impacts of gaining access to health insurance coverage.Although a direct approach to conducting such welfare analysis is through counterfactual policy simulations using structurally estimated parameters, this approach imposes strong modeling assumptions and is computationally challenging. 1 To overcome these limitations, researchers have used a reduced-form approach combined with subjective well-being (SWB) data to evaluate the welfare impacts of several public policies (Deaton, 2018;Gruber & Mullainathan, 2005;Ludwig et al., 2012;Oishi & Diener, 2014) by presuming that SWB data can proxy for an individual's (experienced) utility (Kahneman & Sugden, 2005).In this study, we attempt to provide causal evidence on the effect of health insurance coverage on SWB by analyzing large-scale healthcare reforms in the United States. Federal and state governments in the United States have implemented several reforms to expand health insurance coverage among the uninsured over the past 2 decades. Many studies have evaluated the effects of these healthcare reforms on outcomes such as health, healthcare utilization, household finances,

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“…The association between health insurance and SWB (e.g. happiness, life satisfaction) has been of long-standing interest to researchers and policymakers seeking to understand the broader welfare impacts of gaining health insurance coverage ( Kim and Koh, 2022 ).…”

Research on the Influence of Ecological Environment Satisfaction and Income Level on Chinese Residents’ Happiness: Empirical Analysis Based on CGSS Data

“…Internal factors refer to their own physiological conditions and self-awareness, etc., which may affect the formation of individuals' behavioral habits, mainly including gender [22,23], personality [24,25], health [26,27], religious beliefs [28,29], and values [30,31]. In addition to these, factors such as educational status [32,33] and insurance [34,35] also have a significant impact on residents' happiness.…”

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“…Wu and Li found that health insurance could help older people feel secure and was positively associated with their physical and mental health (41). Kim and Koh found that lack of health insurance had a negative impact on the subjective wellbeing of the general population after controlling for individual self-assessed health status and other socioeconomic factors (42). While the aim of universal health coverage is to ensure equal access to health services, Liao et al found that universal health coverage also improved subjective wellbeing among older people, particularly older women (43).…”