Medicaid expansion, tort reforms, and medical liability costs
研究了美国医疗补助扩展和侵权改革对医疗责任系统的影响，发现扩展州的保险公司成本更高，医生保费上涨但不足以覆盖成本，侵权改革未能缓解相关责任成本。
Abstract This paper examines the impacts of the Affordable Care Act (ACA)'s Medicaid expansion and tort reforms on the medical liability system. Medicaid expansion increased the demand for medical services, but in doing so it may also increase physicians' medical liability. By studying malpractice costs to insurers, medical practitioners, and hospitals in the United States in 2010–2018, we find insurers in Medicaid expansion states experienced higher medical liability costs than those in nonexpansion states. Medical practitioners paid higher premiums in expansion states but the premium increase was not enough to fully offset rising costs. In addition, we do not find that tort reforms mitigated ACA‐induced malpractice liability costs. We show this is because Medicaid expansion increased malpractice costs mainly by increasing claim frequency while tort reforms generally reduce claim severity. We also find little evidence that hospitals paid higher malpractice insurance premiums to insurers or self‐insurance programs, or incurred higher out‐of‐pocket medical liability losses after Medicaid expansion.