  We use a five percent sample of Americans' credit bureau data, combined with
a regression discontinuity approach, to estimate the effect of universal health
insurance at age 65-when most Americans become eligible for Medicare-at the
national, state, and local level. We find a 30 percent reduction in debt
collections-and a two-thirds reduction in the geographic variation in
collections-with limited effects on other financial outcomes. The areas that
experienced larger reductions in collections debt at age 65 were concentrated
in the Southern United States, and had higher shares of black residents, people
with disabilities, and for-profit hospitals.
