Research Seminar with Liam Rose, PhD

The majority of Americans become eligible for Medicare upon turning 65. This results in seven percent of the near elderly transitioning from not having insurance to having insurance. It also results in 13.5% switching from private coverage to Medicare and 46.5% switching from private coverage to Medicare and a second insurer. We develop an extension of two-sample instrumental variables to estimate the effect of no insurance on access to care while accounting for the effects of the other transitions that occur at age 65. We find that not having insurance results in a much lower probability of having a medical provider or getting a checkup. Being uninsured also reduces the probability of receiving treatment as an inpatient by about 13 percentage points. The majority of the foregone hospitalizations are for elective surgeries, many of which have been documented to substantially increase quality of life. In addition, not having insurance results in a very substantial reduction in emergency hospitalizations, some of which are for conditions that can be life threatening if untreated.