Dismantling the Affordable Care Act (ACA) without a replacement plan is projected to increase the nation’s uninsured population by 18 million in the first year after repeal and by 32 million in 2026, according to recent estimates by the Congressional Budget Office (CBO). As lawmakers and the American public consider repealing portions of the ACA, it is an important time to reflect on what limiting access to health insurance might mean for Americans and their communities. If a repeal occurs, not only individuals, but also their communities, could be affected.
Whether we like it or not, health insurance affects our lives in significant ways. Sometimes these effects are very direct, determining whether we can afford to see a doctor when we need to. At other times, health insurance affects us in less direct ways by shaping whether providers hire that extra nurse or relocate to a wealthier area of town.
One of the things we’ve paid a lot less attention to is whether the effects of health insurance go beyond things like health and costs to shape other aspects of our social lives. My new study with Stefan Timmermans of UCLA addresses this gap by examining the consequences of uninsurance for cohesion and trust in Los Angeles communities during the 2000s.
Using longitudinal data from the Los Angeles Family and Neighborhood Survey (L.A. FANS), we find that people living in communities with lower levels of insurance are less likely to feel connected to and trust their neighbors, even after controlling for several other neighborhood and individual factors that might affect people’s perceptions of and engagement with their communities.
We also test whether broader access to health insurance through a policy like the ACA could strengthen communities over time. This analysis demonstrates that people’s perceptions of their neighbors and communities improve as more people gain access to insurance in their community.
Consequences Beyond Health Care
How does this work?
When…