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Reconciling Seemingly Contradictory Results from the Oregon Health Insurance Experiment and the Massachusetts Health Reform

Amanda E. Kowalski

NBER Working Paper No. 24647
Issued in May 2018, Revised in September 2019
NBER Program(s):Program on the Economics of Aging, Health Care Program, Health Economics Program, Public Economics Program, Technical Working Papers

A headline result from the Oregon Health Insurance Experiment is that emergency room (ER) utilization increased. A seemingly contradictory result from the Massachusetts health reform is that ER utilization decreased. I reconcile both results by identifying treatment effect heterogeneity within the Oregon experiment and then extrapolating it to Massachusetts. I find that even though Oregon compliers increased their ER utilization, they were sicker than Oregon never takers, who would have decreased their ER utilization. Massachusetts expanded coverage from a higher level to healthier individuals. Therefore, Massachusetts compliers are comparable to a subset of Oregon never takers, which can reconcile the results.

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Document Object Identifier (DOI): 10.3386/w24647

 
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