The Effect of Broadband on Policy Uptake: Evidence from the Affordable Care Act

• In Event: Health Policy: Challenges and New Directions

Abstract

In 2014 The Affordable Care Act (ACA) was plagued by various issues that fueled bipartisan dissatisfaction with the law. Yet, despite expectations of failure, the Obama administration exceeded its enrollment targets for newly created healthcare marketplaces. In this paper, I argue that this success was due largely because of policy implementation that focused on lowering the conformity costs to the public via the internet, among other means. To test this argument, I estimate the effect of broadband internet availability on the number of uninsured individuals within counties. Using difference-in-differences estimates, I show that counties with more broadband internet providers had sharper declines in the number of uninsured individuals after full-implementation of the ACA than counties with less providers. I also show that this effect is most apparent for states whose political leadership did not support implementing the ACA, and it diminishes within states that either created their own healthcare exchanges or expanded Medicaid. Collectively, my results suggest that broadband internet access may increase the public's participation in programs---particularly in areas that lack other inducements for participation---which has real consequences for policy success.

Author

• Darrian Stacy, The United States Naval Academy