The affordable care act and ambulance response times

Charles Courtemanche; Andrew Friedson; Andrew P Koller; Daniel I Rees

doi:10.1016/j.jhealeco.2019.05.010

The affordable care act and ambulance response times

J Health Econ. 2019 Sep:67:102213. doi: 10.1016/j.jhealeco.2019.05.010. Epub 2019 Jul 9.

Authors

Charles Courtemanche¹, Andrew Friedson², Andrew P Koller², Daniel I Rees³

Affiliations

¹ University of Kentucky, NBER and IZA, United States. Electronic address: courtemanche@uky.edu.
² University of Colorado Denver, United States.
³ University of Colorado Denver, NBER and IZA, United States.

PMID: 31362143
DOI: 10.1016/j.jhealeco.2019.05.010

Abstract

This study contributes to the literature on the capacity challenges faced by health care providers after insurance expansions by examining the Affordable Care Act (ACA) and ambulance response times. Exploiting temporal and geographic variation in the implementation of the ACA as well as pre-treatment differences in uninsured rates, we estimate that the expansions of private and Medicaid coverage under the ACA combined to slow ambulance response times by an average of 24%. We conclude that, through extending coverage to individuals who, in its absence, would not have availed themselves of emergency medical services, the ACA added strain to emergency response systems.

Keywords: Affordable care act; Ambulance; Health care capacity; Health care workforce; Health insurance.

MeSH terms

Ambulances / statistics & numerical data*
Humans
Insurance Coverage / legislation & jurisprudence
Insurance Coverage / statistics & numerical data
Medicaid / statistics & numerical data
Medically Uninsured / statistics & numerical data
Patient Protection and Affordable Care Act*
Surge Capacity
Time Factors
United States