Long-term Individual and Population Consequences of Early-life Access to Health Insurance
Gaining access to health insurance in childhood has been associated with improved childhood health and educational attainment. Expansions in health insurance access have steadily lowered the rates of uninsured children and may have long term consequences for adult health and well being. This paper analyzes the impact of gaining health insurance in childhood on health and economic outcomes during adulthood using dynamic microsimulation. We find disease prevalence at age 65 falls for most chronic conditions, with the exception of cancer. We also find increased access to health insurance in childhood results in 11 additional months of life expectancy and 16 additional months lived free of disability. There is no change in total lifetime medical spending, although both Medicaid and Medicare expenditures fall. Lifetime earnings increase by about 8% for individuals who gain the benefits of childhood health insurance.
Gaining access to health insurance in childhood had long-term consequences for adult well being. Compared to adult health and economic outcomes for individuals without childhood health insurance, gaining health insurance in childhood resulted in:
- A decline in the prevalence at age 65 of most major diseases, excluding cancer;
- An increase in life expectancy of 11 months and 16 additional months lived free of disability;
- No change in lifetime total medical spending as increases in spending due to additional life years were offset by lower health care spending due to improve health;
- A decline in Medicare and Medicaid outlays and expenditures on lifetime Disability Insurance;
- An increase in lifetime earnings of approximately 8 percent.
Gaudette, Étienne, Gwyn C. Pauley, and Julie Zissimopoulos. 2016. "Long-term Individual and Population Consequences of Early-life Access to Health Insurance." Ann Arbor, MI. University of Michigan Retirement Research Center (MRRC) Working Paper, WP 2016-355. https://mrdrc.isr.umich.edu/publications/papers/pdf/wp355.pdf
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Paper IDWP 2016-355