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Good for your fiscal health? The effect of the affordable care act on healthcare borrowing costs

JOURNAL OF FINANCIAL ECONOMICS2022-08

Gao, Pengjie | Lee, Chang Joo | Murphy, Dermot

We study the effect of the US Affordable Care Act (ACA) on healthcare borrowing costs. The ACA provides insurance subsidies to low-income enrollees. States could accept funding to expand Medicaid, although many declined, citing the cost burden. The ACA significantly reduced healthcare yields after a favorable 2012 Supreme Court ruling. Furthermore, hospital investment spending increased, and investment-cash flow sensitivities decreased. The yield effect was double in Medicaid expansion states, and insignificant in rural areas of non-expansion states. Our results highlight how the municipal market can be used to evaluate the heterogeneous effects of public policy and guide a targeted policy approach. (C) 2021 Elsevier B.V. All rights reserved.

Publisher
ELSEVIER SCIENCE SA
Issue Date
2022-08
Article Type
Article
Citation
JOURNAL OF FINANCIAL ECONOMICS, Vol.145, No.2, pp.464 - 488
ISSN
0304-405X
DOI
10.1016/j.jfineco.2021.09.003
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