Abstract
Although the United States has the highest health care spending per capita of any industrialized country, there are over 48 million nonelderly Americans lacking health insurance coverage, which translates to more than 18% of the nonelderly being uninsured. Currently, governments around the world are pursuing strategies to incorporate well-being measures to advance public policy, yet there are few studies that focus on the effects of health insurance coverage on well-being. This study fills the gap by exploring the relationship between well-being, health insurance coverage, health care cost, and Medicaid factors in the United States. Data for this study come from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS) 2010 survey. The BRFSS houses the world’s largest ongoing telephone health survey system with over 350,000 adults interviewed each year. It is designed to measure behavioral risk factors for the adult populations to identify emerging health problems, establish and track health objectives, and develop and evaluate public health policies and programs. In addition to the BRFSS data set, this study also uses data on states’ ranking of Medicaid programs from a 2007 report published by the Public Citizen Health Research Group. Controlling for confounding factors, results from my logistic regression analysis indicated that individuals who could not see a doctor due to cost were 40.7% less likely to be satisfied with life. Similarly, individuals without health insurance coverage were 9.4% less likely to be happy. Moreover, individuals residing in states with a 1-standard-deviation-higher percentage of Medicaid scope of services ranking and Medicaid eligibility ranking have lower odds of being satisfied with life by 6.1% and 2.5%, respectively. However, low-income, self-employed, and unemployed individuals residing in states with more generous Medicaid ranking were found to be happier. These findings add to the existing literature by suggesting that health insurance coverage, ability to see a doctor, and residency in states with more generous Medicaid ranking substantially impact individual well-being. These effects held across income categories and health status, which further emphasized their significant influence on happiness. These findings have major implications for where policymakers should focus their attention.