Eastern Economic Journal

, Volume 45, Issue 1, pp 7–33 | Cite as

Effects of the Affordable Care Act on Health Behaviors After 3 Years

  • Charles Courtemanche
  • James MartonEmail author
  • Benjamin Ukert
  • Aaron Yelowitz
  • Daniela Zapata
Original Article


This paper examines the impacts of the affordable care act (ACA)—which substantially increased insurance coverage through regulations, mandates, subsidies, and Medicaid expansions—on behaviors related to future health risks after 3 years. Using data from the Behavioral Risk Factor Surveillance System and an identification strategy that leverages variation in pre-ACA uninsured rates and state Medicaid expansion decisions, we show that the ACA increased preventive care utilization along several dimensions, but increased risky drinking. These results are driven by the private portions of the law, as opposed to the Medicaid expansion. We also conduct subsample analyses by income and age.


Affordable care act Health insurance Medicaid Health behavior Preventive care 

JEL Classification

I12 I13 I18 

Supplementary material

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Copyright information

© EEA 2018

Authors and Affiliations

  • Charles Courtemanche
    • 1
    • 2
    • 3
  • James Marton
    • 4
    Email author
  • Benjamin Ukert
    • 5
  • Aaron Yelowitz
    • 1
  • Daniela Zapata
    • 6
  1. 1.Department of Economics, Gatton College of Business and EconomicsUniversity of KentuckyLexingtonUSA
  2. 2.National Bureau of Economic ResearchCambridgeUSA
  3. 3.Institute of Labor Economics (IZA)BonnGermany
  4. 4.Department of Economics, Andrew Young School of Policy StudiesGeorgia State UniversityAtlantaUSA
  5. 5.Leonard Davis Institute of Health Economics, University of PennsylvaniaPhiladelphiaUSA
  6. 6.IMPAQ InternationalWashingtonUSA

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