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Record W2148702540 · doi:10.1353/eca.2014.0016

The Early Impact of the Affordable Care Act, State by State

2014· article· en· W2148702540 on OpenAlexaboutno aff
Amanda Kowalski

Bibliographic record

VenueBrookings Papers on Economic Activity · 2014
Typearticle
Languageen
FieldEconomics, Econometrics and Finance
TopicHealthcare Policy and Management
Canadian institutionsnot available
FundersRobert Wood Johnson FoundationNational Science Foundation
KeywordsEnforcementGovernment (linguistics)WelfareHealth insuranceState (computer science)Quarter (Canadian coin)Patient Protection and Affordable Care ActMedicaidWelfare stateHealth carePublic economicsEconomicsBusinessActuarial scienceDemographic economicsPolitical scienceEconomic growthGeographyPoliticsMarket economy

Abstract

fetched live from OpenAlex

In this paper I examine the effects that state policy decisions have had on the early impact of the Affordable Care Act (ACA) using data through the first half of 2014. I focus on the individual health insurance market, which includes plans purchased through exchanges as well as plans purchased directly from insurers. In this market, at least 13.2 million people were covered in the second quarter of 2014, representing an increase of at least 4.2 million beyond pre-ACA state-level trends. I use data on coverage, premiums, and costs and a model developed by Martin Hackmann, Jonathan Kolstad, and myself (forthcoming) to calculate changes in selection and markups, which allow me to estimate the welfare impact of the ACA on participants in the individual health insurance market in each state. I then focus on comparisons across groups of states. The estimates from my model imply that market participants in the five “direct enforcement” states—those that ceded all enforcement of the ACA to the federal government—are experiencing welfare losses of approximately $245 per participant on an annualized basis, relative to participants in all other states. The estimates also imply that the impact of setting up a state exchange depends meaningfully on how well the exchange functions. Market participants in the six states that had severe exchange glitches are experiencing welfare losses of approximately $750 per participant on an annu-alized basis, relative to participants in other states with their own exchanges. Although the national impact of the ACA is likely to change over the course of 2014 as coverage, costs, and premiums evolve, I expect that the differential impacts that are observed across states will persist through the rest of 2014.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.463
Threshold uncertainty score0.986

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.011
GPT teacher head0.234
Teacher spread0.223 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations40
Published2014
Admission routes1
Has abstractyes

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