Paul is currently working to measure the effect of coverage gains under the Affordable Care Act on emergency department and primary care utilization with a focus on the previously uninsured. He is also working to estimate the impact of federal, state, and insurer advertising on consumer engagement with state and federal health insurance exchanges.
MORE ABOUT PAUL
Paul earned his PhD in health policy and management at UNC. He is a first-generation American, college graduate, and graduate student as the only child of parents who defected from then Soviet-controlled Hungary in the 1970s. He is a health economist, focused on health insurance policy and how the use of medical care is influenced by coverage transitions and benefit design. He has also worked as a research economist in the Center for Health Policy Science and Tobacco Research at RTI International (2011 to 2017) and as a junior fellow at the Agency for Healthcare Research and Quality (2018).
DISSERTATION GRANT AWARDEE — APRIL 2018
Effect of the Affordable Care Act on Utilization of Emergency and Primary Care
The Affordable Care Act (ACA) considerably reduced the uninsured rate nationally; however, expanding access to health insurance coverage may not be a sufficient incentive for patients to change how they use health care. This dissertation investigated the effects on the use of emergency and primary care, resulting in 3 key findings—1) there is evidence of pent-up demand for health care but no substitution between ED and primary care among the newly insured, 2) increases in population-level health insurance coverage are not enough to yield reductions in potentially avoidable ED visits, and 3) enrollment in a high deductible health plan discourages use of free preventive services covered by the ACA. All of this together means that expanding health insurance coverage and benefits are part of the solution, but should not be expected to solve sizable inequities in health outcomes and access to care in the United States.
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