Three years ago, 3.9 million Americans received a plain-looking envelope from the Internal Revenue Service. Inside was a letter stating that they had recently paid a fine for not carrying health insurance and suggesting possible ways to enroll in coverage.
New research concludes that the bureaucratic mailing saved lives.

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“I was definitely torn about it,” said Jacob Goldin, a co-author of the paper who worked as an economist at the Treasury Department and is now an associate professor at Stanford. “We were hoping the letters would be beneficial, and wanted them to go to everybody. But it was also an exciting research opportunity.”

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The subsequent research, published by Mr. Goldin with the Treasury economists Ithai Lurie and Janet McCubbin, found that gaining coverage was associated with a 12 percent decline in mortality over the two-year study period (the first months of coverage seemed to be most important, presumably because people could get caught up on various appointments and treatments they might have been missing).

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