# 7 - How Health Insurance Affects Health

> **NIH NIH P01** · NATIONAL BUREAU OF ECONOMIC RESEARCH · 2020 · $153,695

## Abstract

PROJECT SUMMARY/ABSTRACT
Project 7 – How Health Insurance Affects Health
Understanding the consequences of health insurance coverage is central to evaluating proposals to expand or
modify health insurance coverage in the U.S. Yet there is remarkably little convincing evidence on the impact
of insuring the uninsured on their medical utilization, health outcomes, health behaviors, or overall well-being,
largely because enrolling in health insurance is a choice that is made jointly with other choices that determine
these outcomes.
This project takes advantage of a remarkable opportunity to provide just such evidence. For a limited window
in early 2008, Oregon opened a waiting list for enrollment in its public health insurance program for low income
adults, and then randomly drew names from the list to determine who would be given the opportunity to enroll.
This unique policy environment provided researchers with a rare occasion to bring the strengths of random
assignment – the standard in medical trials – to address a critical social policy question. This proposal builds
on our prior work assessing the effects of Medicaid on health care use, health, and well-being, including a
focus on the near-elderly (those aged 50-64) whose health risks are in many ways similar to those aged 65
and up and who will soon age onto Medicare themselves. We found that Medicaid substantially increased
health care use across settings (including primary care, hospitals, prescription drugs, and emergency
departments (EDs)); reduced financial strain (including bills sent to collection and catastrophic out-of-pocket
expenses); and reduced the prevalence of depression; but had no detectable effects on several measures of
physical health (including blood pressure, cholesterol, and diabetic blood sugar control).
This project will leverage our work on the Oregon Health Insurance Experiment to build several new data sets
and conduct new analyses to assess multi-faceted effects of Medicaid coverage on health and other outcomes,
including: care and health outcomes for chronic physical conditions and mental health, including diabetes,
asthma, and depression; patterns of ED and hospital use over time and substitutability of different sites of care;
and dental care and outcomes. We will also develop a novel econometric method for assessing and
synthesizing the multidimensional effects of insurance on health. As policy-makers and stakeholders assess
the broad consequences of expanded access to health insurance, we believe these analyses will add crucial
evidence on the many potential effects of Medicaid on health care use, quality, and long-term health outcomes
of an aging population.

## Key facts

- **NIH application ID:** 9990670
- **Project number:** 5P01AG005842-32
- **Recipient organization:** NATIONAL BUREAU OF ECONOMIC RESEARCH
- **Principal Investigator:** Katherine Baicker
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $153,695
- **Award type:** 5
- **Project period:** — → —

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9990670

## Citation

> US National Institutes of Health, RePORTER application 9990670, 7 - How Health Insurance Affects Health (5P01AG005842-32). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9990670. Licensed CC0.

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