Health Insurance Coverage and Risky Health Behaviors among Young Adults

Abstract

Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. This paper investigates the relationship between health insurance coverage and risky health behaviors among young adults using the confidential version of the National Longitudinal Survey of Youth, 1997 Cohort (NLSY97). Before the Affordable Care Act required all employers to provide health insurance to employees' children until the age of 26 (before September, 2010), many health insurance contracts covered dependents through age 19. Using a regression discontinuity design framework, I find that approximately 6 percent of young adults lose their health insurance coverage once they turn 19. I also find some evidence that the discrete change in health insurance coverage status at age 19 has spillover effects on heavy drinking, especially for males, but does not have any significant impact on smoking or marijuana use habits of young adults. These results are robust under several different parametric and non-parametric models and not sensitive to the selection of samples based on gender. Terms of use: Documents inJEL-Code: I120, I130, I180.

Health insurance coverage and health care utilization: Evidence from the Affordable Care Act’s dependent coverage mandate

“…They also show that the discrete change in health insurance coverage status at these ages leads to significant reductions in self-reported health status, emergency department and hospital visits, and inpatient hospital admissions. Furthermore, Yörük (2015)…”

Health insurance coverage and self-reported health: new estimates from the NLSY97

“…Moreover, she finds a a small increase in out-of-pocket health expenditures, but no change in health status or ability to afford care at age 19. Yörük (2015) finds that effect of the discrete change in health insurance coverage at age 19 on risky health behaviors is relatively small and often statistically insignificant. Using data from National Health Interview Survey (NHIS), Cardella and Depew (2014) find that having health insurance coverage significantly increases the likelihood of reporting excellent health among young adults who just turn 19.…”

The effects of public health insurance on health behaviors: Evidence from the fifth year of Medicaid expansion

“…Results for risky behaviors are more mixed. The majority of studies find no detectable effects of either private or public health insurance on risky behaviors (Baicker et al, 2013; Barbaresco et al, 2015; Brook et al, 1983; Cawley et al, 2018; Courtemanche, Marton, Ukert, Yelowitz, & Zapata, 2018; Courtemanche et al, 2019; Donahoe et al, 2019; Simon et al, 2017; Yörük, 2017). However, some find evidence that insurance coverage leads to some ex ante moral hazard, such as increases in BMI and obesity (Asfaw, 2019; Bhattacharya, Bundorf, Pace, & Sood, 2011; Kelly & Markowitz, 2009; Klick & Stratmann, 2007; Stanciole, 2008), increases in smoking and risky drinking (Barbaresco et al, 2015; Dave & Kaestner, 2009; Dave, Kaestner, & Wehby, 2019; Stanciole, 2008), reductions in exercise (Asfaw, 2019; Dave & Kaestner, 2009; Stanciole, 2008), and increases in risky sexual behaviors (Willage, 2019).…”