The impact of the Uniform Accident and Sickness Policy Provision Law on Alcohol Consumption and Alcohol Consumption Related Outcomes - The impact of the Uniform Accident and Sickness Policy Provision Law on alcohol consumption and alcohol consumption related outcomes Project Summary The Uniform Accident and Sickness Policy Provision Law (UPPL) in many U.S. states’ insurance codes are intended to discourage problem drinking by permitting insurance companies to deny claims for injuries resulting from alcohol impairment or the use of non-prescribed narcotics. Although the primary intention behind UPPLs was to discourage excessive drinking and substance use, evidence suggests that these laws have unintended consequences, as they crease a disincentive for physicians to test the blood alcohol concentration (BAC) levels of injured patients due to concerns about potential insurance reimbursement denials. Recognizing this, a major stakeholder, the National Association of Insurance Commissioners (NAIC), changed its stance in 2001 to support health insurance coverage regardless of intoxication status. However, despite this shift, many states still retain their UPPLs. The existing literature on the impact the UPPL on alcohol consumption and alcohol consumption related outcomes is mostly descriptive and studies that provide a credible estimation methodology focus on the effects of UPPLs on a very limited number of outcomes. Furthermore, existing studies focus on the effects of the repeal of UPPLs. However, repeal of the UPPL does not guarantee that insurance companies cannot deny claims resulting from alcohol impairment unless the repeal of the UPPL was simultaneously occurred with the introduction of another law that explicitly prohibited the denial of claims due to intoxication. Some states either did not have a UPPL law to begin with or did not introduce any law that prohibits denial of insurance claims due to alcohol involvement following the repeal of the UPPL. In these states, without the existence of any law that explicitly prohibits denials, courts have ruled that insurance companies can still deny claims due to alcohol involvement. Therefore, a more accurate assessment of the effectiveness of the UPPLs should rely on separate comparison of the outcomes of the states where denial is explicitly permitted with those where denial is prohibited and those where no UPPL related law exists. The proposed project will be the first to provide a comprehensive analysis of the effects of the UPPLs on alcohol consumption both at the intensive and extensive margin. In addition to its effects on alcohol consumption, the proposed project will also be the first to provide evidence on the spillover effects of these laws on alcohol related outcomes such as drunk driving behavior, alcohol and drug related traffic fatalities, driving under influence (DUI) arrests, number of emergency department (ED) visits, and out-of-pocket healthcare expenses for alcohol and drug related ED visits. We will exploit the variation in UPPLs across different states and over time to conduct event study and difference-in-differences (DID) analyses of the effect of the policy on alcohol consumption and related outcomes. The results from this study will provide policy makers with new, important information about the effectiveness of UPPLs and contribute to the recent policy discussion on whether these laws should be repealed.
