Health Insurance and Mortality: Experimental Evidence from Taxpayer Outreach

Jacob Goldin, Ithai Z. Lurie, Janet McCubbin

NBER Working Paper No. 26533
Issued in December 2019
NBER Program(s):Program on the Economics of Aging, Health Care Program, Health Economics Program, Public Economics Program

We evaluate a randomized pilot study in which the IRS sent informational letters to 3.9 million taxpayers who paid a tax penalty for lacking health insurance coverage under the Affordable Care Act. Drawing on administrative data, we study the effect of the intervention on taxpayers’ subsequent health insurance enrollment and mortality. We find the intervention led to increased coverage in the two years following treatment and that this additional coverage reduced mortality among middle-aged adults over the same time period. Our results provide the first experimental evidence that health insurance reduces mortality.

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Acknowledgments

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Document Object Identifier (DOI): 10.3386/w26533