The heterogeneous impact of insurance on health care demand among young adults: a panel data analysis

Success of the recently implemented Affordable Care Act hinges on previously uninsured young adults enrolling in coverage. How will increased coverage, in turn, affect health care utilization? This paper applies variable coefficient panel models to estimate the impact of insurance on health care utilization among young adults. The econometric setup, which accommodates nonlinear usage measures, attempts to address the potential endogeneity of insurance status. The main finding is that, for approximately one-fifth of young adults, insurance does not substantially alter health care consumption. On the other hand, another one-fifth of young adults have large moral hazard effects. Among that group, insurance increases the probability of having a routine checkup by 71-120%, relative to mean probabilities, and insurance increases the number of curative-based doctor office visits by 67-181%, relative to the mean number of visits.