John Cawley, co-director of Cornell University’s Institute on Health Economics and an expert on the economics of risky health behaviors, studied the impact of the Affordable Care Act on preventive care and found that one of the more controversial features of the law – state-level expansions of Medicaid – improved preventive care among low-income Americans, and yielded other benefits as well to this vulnerable population.
“The expansions of Medicaid promoted by the Affordable Care Act (ACA) have had numerous benefits. They provide low-income individuals with health insurance coverage and access to care. They are also increasing some forms of preventive care, such as dental visits.
“One might be concerned that, if people know that if they get sick then most of their costs will be covered by insurance, they would take less care of themselves or take more risks. We don’t find any evidence of that kind of moral hazard with respect to smoking, heavy drinking or lack of exercise.
“If the entire ACA literally disappeared and there was no replacement, we’d see millions of people lose health insurance. We’d see decreases in preventive care. Down the road, that would mean more people would be sick, and the health care system would be more burdened.”
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