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The vast majority of Americans become eligible for Medicare at
age 65. This results in 7 percent of the near elderly transitioning
from uninsurance to insurance and 60 percent switching from some
source of insurance to Medicare. We develop an extension of two-sample
IV to estimate the effect of uninsurance on access to care
while accounting for the effects of the other transitions. We find
that not having insurance results in much lower probabilities of
having a medical provider or receiving inpatient care. The foregone
hospitalizations are for life-threatening emergent conditions and
elective surgeries that increase quality of life.