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健康保险与死亡率:纳税人联络干预的实验证据

Health Insurance and Mortality: Experimental Evidence from Taxpayer Outreach
Quarterly Journal of Economics · 2020 · Jacob Goldin、Ithai Z. Lurie、Janet McCubbin

中文摘要

我们评估了一项随机联络研究,美国国税局(IRS)向390万户因未按《平价医疗法案》要求参加健康保险而缴纳税收罚款的家庭寄送了信息函。利用行政数据,我们研究了这一干预对纳税人此后健康保险参保与死亡率的影响。我们发现,该干预提高了随后两年内的保险覆盖率,并降低了同期中年成年人的死亡率。这些结果提供了实验证据,表明健康保险覆盖可以降低美国的死亡率。

Abstract

Abstract We evaluate a randomized outreach study in which the IRS sent informational letters to 3.9 million households that paid a tax penalty for lacking health insurance coverage under the Affordable Care Act. Drawing on administrative data, we study the effect of this intervention on taxpayers’ subsequent health insurance enrollment and mortality. We find the intervention led to increased coverage during the subsequent two years and reduced mortality among middle-aged adults over the same time period. The results provide experimental evidence that health insurance coverage can reduce mortality in the United States.
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