Job Market Paper
Exploring the Differential Impact of Repealing the ACA Individual Mandate by Health Status
Abstract
This paper examines how the 2019 elimination of the Affordable Care Act (ACA)
individual mandate penalty affected insurance outcomes by health status.
Using nationally representative CPS ASEC data, I exploit cross-state
variation in mandate enforcement by comparing states without enforceable
mandates with Massachusetts, New Jersey, and the District of Columbia,
which had enforceable mandates in 2019. The policy increased the probability
of becoming newly uninsured, with a statistically significant increase among
relatively healthy consumers but not among relatively sick consumers.
The benchmark Marketplace premium for a 27-year-old increased by $739,
while reported out-of-pocket premium spending declined by $284.60.
Financial-incidence analysis suggests that accounting for ACA subsidies attenuates
the financial burden that would otherwise fall more heavily on relatively sick consumers.
The findings show that the incidence of adverse selection depends not only on Marketplace
premiums but also on how public subsidies shape consumers’ exposure to premium increases.
Working Papers
Does the Tobacco 21 Minimum Legal Sales Age Policy Improve Respiratory Health? Evidence from the United States
Abstract
Tobacco use is a leading contributor to preventable respiratory morbidity, yet empirical evaluations
of tobacco-control policies have largely focused on behavioral responses rather than health outcomes.
We examine whether Tobacco-21 minimum legal sales age (MLSA) laws affect smoking and asthma
prevalence among young adults aged 18–20. Using Behavioral Risk Factor Surveillance System data
from 2011–2019, we exploit the staggered adoption of Tobacco-21 laws across U.S. states using the
Callaway and Sant’Anna (2021) difference-in-differences estimator, which accommodates heterogeneous
treatment timing. We find that smoking estimates are consistently negative, ranging from approximately 2 to 4
percentage points, although statistical significance varies across specifications. In contrast, we find no
statistically detectable short-run effect on asthma prevalence. The asthma estimates are imprecise and do
not rule out economically meaningful effects in either direction. These findings highlight the importance
of distinguishing immediate behavioral responses from health outcomes that may require longer follow-up
periods to detect.
Works in Progress
- Beyond the Beneficiary: Spousal Spillover Effects of Medicare Part D Among SSDI Medicare Beneficiaries.
- The Impact of Non-Financial Incentives on Infant and Maternal Health: Evidence from Nigeria’s Abiye (Safe Motherhood) Program
- Individual Mandate Policy and Preventive Care (with S. Olanrewaju, S. Mukherjee, J. Josephs, Y. M. Fomene, M. Agbede).
Publications
The Determinants of Micro, Small and Medium Enterprises' (MSMEs) Performance in Nigeria: Evidence from Business Enterprise Survey
Development Bank of Nigeria Journal of Economics and Sustainable Growth , 3(1), 21–45, 2020.
Public Debt Sustainability in Nigeria after the Exit from Paris Club: The Role of Structural Breaks
Acta Universitatis Danubius (Economica) Journal , 15(7), 148–163, 2019.
Predicting Exchange Rate with Commodity Prices: New Evidence from Westerlund and Narayan (2015) Estimator with Structural Breaks and Asymmetries
Resources Policy , 62(1), 33–56, 2019.