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The Affordable Care Act’s Coverage Impacts in the Trump Era
The 2016 US presidential election created uncertainty about the future of the Affordable Care Act (ACA) and led to postponed implementation of certain provisions, reduced funding for outreach, and the removal of the individual mandate tax penalty. In this article, we estimate how the causal impact o...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504697/ https://www.ncbi.nlm.nih.gov/pubmed/34619998 http://dx.doi.org/10.1177/00469580211042973 |
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author | Courtemanche, Charles Fazlul, Ishtiaque Marton, James Ukert, Benjamin Yelowitz, Aaron Zapata, Daniela |
author_facet | Courtemanche, Charles Fazlul, Ishtiaque Marton, James Ukert, Benjamin Yelowitz, Aaron Zapata, Daniela |
author_sort | Courtemanche, Charles |
collection | PubMed |
description | The 2016 US presidential election created uncertainty about the future of the Affordable Care Act (ACA) and led to postponed implementation of certain provisions, reduced funding for outreach, and the removal of the individual mandate tax penalty. In this article, we estimate how the causal impact of the ACA on insurance coverage changed during 2017 through 2019, the first 3 years of the Trump administration, compared to 2016. Data come from the 2011–2019 waves of the American Community Survey (ACS), with the sample restricted to non-elderly adults. Our model leverages variation in treatment intensity from state Medicaid expansion decisions and pre-ACA uninsured rates. We find that the coverage gains from the components of the law that took effect nationally—such as the individual mandate and regulations and subsidies in the private non-group market—fell from 5 percentage points in 2016 to 3.6 percentage points in 2019. In contrast, the coverage gains from the Medicaid expansion increased in 2017 (7.0 percentage points) before returning to the 2016 level of coverage gains in 2019 (5.9 percentage points). The net effect of the ACA in expansion states is a combination of these trends, with coverage gains falling from 10.8 percentage points in 2016 to 9.6 percentage points in 2019. |
format | Online Article Text |
id | pubmed-8504697 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-85046972021-10-12 The Affordable Care Act’s Coverage Impacts in the Trump Era Courtemanche, Charles Fazlul, Ishtiaque Marton, James Ukert, Benjamin Yelowitz, Aaron Zapata, Daniela Inquiry Original Research Article The 2016 US presidential election created uncertainty about the future of the Affordable Care Act (ACA) and led to postponed implementation of certain provisions, reduced funding for outreach, and the removal of the individual mandate tax penalty. In this article, we estimate how the causal impact of the ACA on insurance coverage changed during 2017 through 2019, the first 3 years of the Trump administration, compared to 2016. Data come from the 2011–2019 waves of the American Community Survey (ACS), with the sample restricted to non-elderly adults. Our model leverages variation in treatment intensity from state Medicaid expansion decisions and pre-ACA uninsured rates. We find that the coverage gains from the components of the law that took effect nationally—such as the individual mandate and regulations and subsidies in the private non-group market—fell from 5 percentage points in 2016 to 3.6 percentage points in 2019. In contrast, the coverage gains from the Medicaid expansion increased in 2017 (7.0 percentage points) before returning to the 2016 level of coverage gains in 2019 (5.9 percentage points). The net effect of the ACA in expansion states is a combination of these trends, with coverage gains falling from 10.8 percentage points in 2016 to 9.6 percentage points in 2019. SAGE Publications 2021-10-07 /pmc/articles/PMC8504697/ /pubmed/34619998 http://dx.doi.org/10.1177/00469580211042973 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Article Courtemanche, Charles Fazlul, Ishtiaque Marton, James Ukert, Benjamin Yelowitz, Aaron Zapata, Daniela The Affordable Care Act’s Coverage Impacts in the Trump Era |
title | The Affordable Care Act’s Coverage Impacts in the Trump Era |
title_full | The Affordable Care Act’s Coverage Impacts in the Trump Era |
title_fullStr | The Affordable Care Act’s Coverage Impacts in the Trump Era |
title_full_unstemmed | The Affordable Care Act’s Coverage Impacts in the Trump Era |
title_short | The Affordable Care Act’s Coverage Impacts in the Trump Era |
title_sort | affordable care act’s coverage impacts in the trump era |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504697/ https://www.ncbi.nlm.nih.gov/pubmed/34619998 http://dx.doi.org/10.1177/00469580211042973 |
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