The effect of a driver's license suspension on access to health care

Every year approximately 3.6 million Americans miss or delay health care due to transportation barriers. Though lacking access to a vehicle is the most commonly reported transportation barrier to care, 43 states currently have policies to suspend driver’s licenses as a means of compelling compliance with laws and regulations unrelated to driving (e.g., failure to pay a court fee or appear in court). Approximately 80% of all suspensions are for a non-driving-related offense, and the impact of these suspensions falls primarily on low-income and racial/ethnic minority drivers. Supporters of suspensions view them as one of a limited set of tools for compelling compliance with state regulations. However, little is known about the population of suspended drivers, or the unintended consequences of a suspension for accessing health care. We propose to close this gap using a unique dataset of linked driver’s licensing histories with Medicare and Medicaid claims to provide the first individual level descriptions of this population and how it has changed over time. In the last two years, six states have passed legislation ending non-driving-related license suspensions and several more are considering doing the same. The findings from our proposed work will provide policy makers with the essential information on suspended drivers necessary for developing informed and effective suspension policies and will establish the empirical foundation required for extending our work to estimate the causal effect of a suspension on access to health care, health care utilization and ultimately health outcomes.