Does increasing health care access reduce disability insurance caseloads? Evidence from the rural United States

Abstract

This paper leverages the expansion of the United States' Community Health Center program over the 21st century to investigate whether improved access to health care reduces disability insurance (DI) participation at the county level. I find that the introduction of a health center that specializes in mental health and substance abuse services is associated with a 0.09 to 0.40 percentage point reduction in working-age DI enrollment in rural counties. A cost-benefit analysis indicates that the money saved from reduced program participation can account for more than a third of the cost the federal government faces in funding well-targeted health care access initiatives.