Social and Behavioral Sciences Commons^™

In 2006, Massachusetts enacted comprehensive health care reform which served as a model for the Affordable Care Act. I study the mortality effects of the reform using synthetic control estimation, relaxing two critical assumptions required to implement this method.  The traditional approach assumes the existence of a perfect synthetic control, which cannot exist if the outcomes of the treated unit are outside of the "convex hull" or functions of transitory shocks.  I propose simple modifications to relax these restrictions.  The new estimator outperforms the traditional method in simulations.   I estimate that the Massachusetts Health Care Reform reduced mortality by 3%.