The affordable care act and ambulance response times

Charles Courtemanche, Andrew Friedson, Andrew P. Koller, Daniel I. Rees

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


This study contributes to the literature on the capacity challenges faced by health care providers after insurance expansions by examining the Affordable Care Act (ACA) and ambulance response times. Exploiting temporal and geographic variation in the implementation of the ACA as well as pre-treatment differences in uninsured rates, we estimate that the expansions of private and Medicaid coverage under the ACA combined to slow ambulance response times by an average of 24%. We conclude that, through extending coverage to individuals who, in its absence, would not have availed themselves of emergency medical services, the ACA added strain to emergency response systems.

Original languageEnglish
Article number102213
JournalJournal of Health Economics
StatePublished - Sep 2019

Bibliographical note

Publisher Copyright:
© 2019 Elsevier B.V.


  • Affordable care act
  • Ambulance
  • Health care capacity
  • Health care workforce
  • Health insurance

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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