Expansion of subsidized health insurance may result in both safer and riskier health behavior and outcomes. While having insurance lowers cost barriers to receive both usual and preventive care, the lower potential cost from adverse health events may also promote risky behavior. In this paper, I exploit expansion in the Medicaid program under the Affordable Care Act to estimate the impact of insurance expansion on health outcomes and behaviors for low-income individuals in the US. I find that expansion of coverage has significantly lowered cost and increased access, particularly among minority populations, but has had no significant impact on preventive health behaviors. At the same time, I also find no evidence of moral hazard or increase risky behavior like smoking and drinking among residents of expansion states.

补贴健康保险的扩大可能会导致更安全和风险更高的健康行为和结果。虽然拥有保险可以降低接受常规护理和预防性护理的成本障碍，但不良健康事件的潜在成本较低也可能会促进危险行为。在本文中，我利用平价医疗法案下医疗补助计划的扩展来估计保险扩展对美国低收入个人的健康结果和行为的影响。我发现扩大覆盖范围显着降低了成本并增加了获取机会，特别是在少数群体中，但对预防性健康行为没有重大影响。同时，我也没有发现扩张州居民存在道德风险或增加吸烟和饮酒等危险行为的证据。