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Econ Inq. 2019 Oct;57(4):1798-1820. doi: 10.1111/ecin.12794. Epub 2019 May 7.

Public insurance expansions and smoking cessation medications.

Author information

1
Associate Professor, Department of Economics, Temple University, Research Associate, National Bureau of Economics, Research Affiliate, Institute for Labor Economics, Ritter Annex 869 -- 1301 Cecil B Moore Avenue, Philadelphia PA, 19122.
2
Assistant Professor, Department of Economics, Andrew Young School of Policy Studies, Georgia State University, PO Box 3992, Atlanta GA, 30302-3992.
3
Senior Economist, Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, 5600 Fishers Lane, Mail Stop 07W41A, Rockville MD 20857.

Abstract

We study the effect of public insurance on smoking cessation medication prescriptions and financing. We leverage variation in insurance coverage generated by recent Affordable Care Act expansions to Medicaid. We estimate differences-in-differences models using administrative data on the universe of Medicaid-financed prescriptions sold in retail and online pharmacies 2011-2017. Our findings suggest that these expansions increased Medicaid-financed smoking cessation prescriptions by 34%. This increase reflects new medication use and a shift in payment from private insurers and self-paying patients to Medicaid. Adjusting our estimate for changes in financing implies that Medicaid expansion lead to a 24% increase in new medication use.

KEYWORDS:

I1; I13; I18; JEL classification; Smoking cessation; expenditures; healthcare; prescriptions; public insurance

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