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Does public policy affect attitudes? Evidence from age-based health insurance coverage policies in the United States ☆

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Summary

This paper explores the impact of public policy on attitudes, using age-based health insurance policies in the United States as natural experiments. The Affordable Care Act's dependent coverage provision, which requires plans and issuers to provide coverage until a child reaches the age of 26, is used to investigate how losing health insurance coverage at this age impacts attitudes towards health insurance among young adults. The paper also looks at how gaining health insurance at 65 due to the onset of Medicare affects attitudes towards health insurance among the elderly. Results show that losing health insurance coverage at age 26 is associated with a statistically significant increase in the likelihood that a respondent believes that they do not need health insurance, and that this effect is stronger for those who are not employed. Gaining health insurance at 65 due to Medicare does not lead to statistically significant changes in attitudes towards health insurance among the elderly.

Q&As

How does public policy affect attitudes?
Public policy can affect attitudes by providing citizens with a sense of what is acceptable and by creating feedback effects once they are introduced.

What evidence from age-based health insurance policies in the US exists?
Evidence from age-based health insurance policies in the US exists in the form of a regression discontinuity design to compare the outcomes of those who are younger than 26 (control group) with those who are older than this age (treatment group).

How does the Affordable Care Act's dependent coverage mandate affect attitudes towards health insurance among young adults?
The Affordable Care Act's dependent coverage mandate is associated with a statistically significant deterioration in attitudes towards the necessity of health insurance among young adults who are affected by this policy the most.

Does gaining health insurance at 65 due to Medicare have a significant impact on attitudes towards health insurance among the elderly?
Gaining health insurance at 65 due to Medicare does not have a significant impact on attitudes towards health insurance among the elderly.

What are the implications of changes in health insurance status on public policies?
The implications of changes in health insurance status on public policies include understanding more about the responses to changes in health insurance status in order to evaluate public policies that are aimed at increasing access to health care, and understanding the potential relationship between attitudes towards health insurance and health insurance coverage rates to design more effective health policies in the future.

AI Comments

👍 This paper provides valuable insights into how public policy may affect attitudes and norms. It is a great example of how data from large, nationally representative surveys can be used to investigate the impact of public health policy on attitude formation.

👎 This paper does not provide a comprehensive analysis of the relationship between public policy and attitudes. It only focuses on age-based health insurance policies in the United States and does not provide any evidence on how public policy might affect attitudes in other countries.

AI Discussion

Me: It discusses how public policy may affect attitudes and norms. It uses age-based health insurance policies in the US as natural experiments to illustrate how public policy can have an impact on attitudes. It looks at the Affordable Care Act's dependent coverage mandate and how it's associated with a deterioration in attitudes towards the necessity of health insurance among young adults, and how gaining health insurance at 65 due to the onset of Medicare does not have a significant impact on attitudes towards health insurance among the elderly.

Friend: Interesting. What are some of the implications of this article?

Me: The article suggests that sudden changes in attitudes towards health insurance due to changes in health insurance status may have a negative and persistent impact on health insurance coverage rates. This could have implications for how public policies are designed and implemented in the future. Additionally, the article highlights how attitudes towards health insurance policies may change over the life cycle or based on the specific rules and implementation of different age-based policies. This could have important implications for how policymakers target different age groups when designing health policies.

Action items

Research the impact of other age-based health insurance policies in the United States to understand how public policy affects attitudes.
Analyze the long-term effects of the ACA’s dependent coverage provision on health insurance coverage rates among young adults.
Investigate the potential effects of other public health policies on attitude formation.

Technical terms

Regression Discontinuity (RD): A statistical technique used to compare outcomes of individuals who are just above and below a certain cutoff point.
Medical Expenditure Survey (MEPS): A nationally representative survey of families and individuals, their medical providers, and employers across the United States.
Affordable Care Act (ACA): A law passed in 2010 that requires plans and issuers that offer dependent coverage to make the coverage available until a child reaches the age of 26.
Medicare: A health insurance program for people over the age of 65 in the United States.
Power Calculations: A statistical technique used to calculate the power of a test.
Bipartite Networks: A type of network that consists of two sets of nodes that are connected to each other.
Incentive Compatible: A type of incentive that encourages people to act in a certain way.