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

47 Pages Posted: 30 May 2018 Last revised: 7 Jun 2021

See all articles by Amanda Kowalski

Amanda Kowalski

University of Michigan at Ann Arbor - Department of Economics

Date Written: May 2018

Abstract

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 extrapolating it to Massachusetts. Even though Oregon compliers increased their ER utilization, they were adversely selected relative to Oregon never takers, who would have decreased their ER utilization. Massachusetts expanded coverage from a higher level to healthier compliers. Therefore, Massachusetts compliers are comparable to a subset of Oregon never takers, which can reconcile the results.

Suggested Citation

Kowalski, Amanda, Reconciling Seemingly Contradictory Results from the Oregon Health Insurance Experiment and the Massachusetts Health Reform (May 2018). NBER Working Paper No. w24647, Available at SSRN: https://ssrn.com/abstract=3185920

Amanda Kowalski (Contact Author)

University of Michigan at Ann Arbor - Department of Economics ( email )

Ann Arbor, MI
United States

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