Who Pays for Obesity? Evidence from Health Insurance Benefit Mandates

Is there an obesity externality? In the late 1990s and early 2000s, many state governments began requiring health insurance plans to cover treatments for diabetes. Using difference-in-difference analysis of restricted geocode data from the 1979 National Longitudinal Survey of Youth to compare wages across states with and without diabetes mandates, I find that obese people pay for all of their own increased health costs in the form of lower wages, rather than passing them on to employers, insurers, and co-workers.