Author: Craig Garthwaite
Publisher:
ISBN:
Category : Economics
Languages : en
Pages : 0
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We study the effect of public health insurance eligibility on labor supply by exploiting the largest public health insurance disenrollment in the history of the United States. In 2005, approximately 170,000 Tennessee residents abruptly lost public health insurance coverage. Using both across- and within-state variation in exposure to the disenrollment, we estimate large increases in labor supply, primarily along the extensive margin. The increased employment is concentrated among individuals working at least 20 hours per week and receiving private, employer-provided health insurance. We explore the dynamic effects of the disenrollment and find an immediate increase in job search behavior and a steady rise in both employment and health insurance coverage following the disenrollment. Our results suggest a significant degree of "employment lock" - workers employed primarily in order to secure private health insurance coverage. The results also suggest that the Affordable Care Act - which similarly affects adults not traditionally eligible for public health insurance - may cause large reductions in the labor supply of low-income adults.
Author: Craig L. Garthwaite
Publisher:
ISBN:
Category : Economics
Languages : en
Pages : 66
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Book Description
We study the effect of public health insurance eligibility on labor supply by exploiting the largest public health insurance disenrollment in the history of the United States. In 2005, approximately 170,000 Tennessee residents abruptly lost public health insurance coverage. Using both across- and within-state variation in exposure to the disenrollment, we estimate large increases in labor supply, primarily along the extensive margin. The increased employment is concentrated among individuals working at least 20 hours per week and receiving private, employer-provided health insurance. We explore the dynamic effects of the disenrollment and find an immediate increase in job search behavior and a steady rise in both employment and health insurance coverage following the disenrollment. Our results suggest a significant degree of "employment lock" - workers employed primarily in order to secure private health insurance coverage. The results also suggest that the Affordable Care Act - which similarly affects adults not traditionally eligible for public health insurance - may cause large reductions in the labor supply of low-income adults.
Author: Elena Gouskova
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
Using Social Security Administration (SSA) data on employment and Census population estimates, we re-examine the labor supply effect of a public health insurance disenrollment that took place in Tennessee in 2005. The disenrollment left about 4 percent of Tennessee's non-elderly, adult population without public coverage and was previously reported to have caused large increases in labor supply. These labor supply increases were interpreted as evidence of "employment lock." In contrast to the previous research conducted with the Current Population Survey (CPS), we find no such labor supply increases in SSA/Census data. Furthermore, our findings using CPS data contradict the "employment lock" interpretation. We find, for example, that Tennessee's employment rates increases are driven by decreases in population rather than increases in total employment. Our results narrow the range of existing estimates of the effect of Medicaid on labor supply and highlight importance of considering data error when analyzing survey data.
Author: Catherine G. McLaughlin
Publisher: The Urban Insitute
ISBN: 9780877667193
Category : Business & Economics
Languages : en
Pages : 344
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Book Description
The United States is unique in the industrialized world in the number of people without health insurance. In 2002, nearly 44 million Americans did not have health insurance coverage. Despite long-running study of this problem, the political debate on health insurance is often based on conventional wisdom and studies that haven't been integrated into a careful theoretical framework. In Health Policy and the Uninsured, leading experts in health policy survey the literature on this subject, synthesizing a wide range of health insurance studies into a comprehensive overview of the uninsured. They consider the methodological hurdles involved in the research, explore the complex interaction between health insurance and labor supply, and highlight the special issues facing children, racial or ethnic minorities and immigrants, the near-elderly, and people with psychiatric or substance abuse disorders. This coordinated critique serves several purposes: First, it summarizes for policy makers what we do not know about the uninsured. Second, it provides a framework for the health policy research needed to fill the remaining gaps in our knowledge. And finally, it serves as a useful primer for economists and other policy analysts.
Author: Ana Ines Rocca
Publisher:
ISBN:
Category :
Languages : en
Pages : 148
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Book Description
In the United States, health insurance is often necessary for access to regular, affordable health care. With only eight of every hundred Americans buying private insurance plans on the individual market, the main sources for health insurance traditionally have been employers and the government. As new laws are being debated and introduced to reform an expensive health care industry in which nearly one-sixth of the population is uninsured, research is needed in order to evaluate the costs and benefits of these policy changes and to predict their success. To this end, in addition to understanding how likely individuals are to adopt new health insurance policies, we also should be interested in knowing how the demand for health insurance and changes in its accessibility will affect non-medical decisions. Specifically, labor market choices have been theorized to be directly related to decisions involving insurance coverage. If the availability of health insurance distorts a workers' job-related decisions, then the changing the landscape for how to access insurance may reverberate in employment outcomes. My dissertation focuses on understanding the factors that influence the demand for health insurance and the role that health insurance plays in an individual's decision to work, where to work, and how much to work. Specifically, I focus on the following three related questions: how does the demand for insurance affect labor market decisions such as when to exit unemployment? what drives insurance demand, and in particular, what motivators work best to increase demand for health coverage among the uninsured? and lastly, what are the supply-side employment responses to the provision of free or reduced-cost public health insurance? My first chapter explores how the demand for health insurance can change re-employment decisions among the unemployed, as well as the speed at which individuals return to work. Past research on this issue focuses on job-to-job switches and "job lock" but has yet to focus on individuals looking for work. This chapter uses data on laid-off individuals from the Medical Expenditure Panel Survey to compare the job search behavior and outcomes of individuals who differ in their demand for health insurance. I use three proxies for demand, based on spousal health and past insurance offer take-up decisions. Although each is potentially confounded by unobserved determinants of job search, I use a difference-in-differences and propensity score designs to isolate plausibly causal effects. I find consistent patterns across all three proxies (despite different potential omitted variables biases). Overall unemployment durations do not vary with demand for insurance, but this masks variation in the types of jobs taken. Individuals with higher demand for insurance have higher hazards for exiting unemployment into a job with insurance, but lower hazards for exiting to a job without insurance. This points to effects of insurance demand on both search effort and reservation wages, and to potentially important distorting effects of employer-linked health insurance. Whereas the first chapter takes variation in demand for insurance as a given, my second chapter digs deeper into the basis for this variation and whether it can be affected. In this chapter, I investigate the reasons the uninsured choose to forego insurance coverage and the impact of different messages on their insurance demand. Working with Enroll America, a large non-profit dedicated to decreasing the number of uninsured Americans, I conducted a stratified experiment to determine the best communication strategies to encourage participation in the healthcare exchanges. We test a combination of the following behavioral and information treatments: a risk treatment that emphasizes the average financial risk for someone without health insurance; a norms treatment that alerts our participants that staying uninsured will be against the law; a savings treatment that highlights the average savings available at the exchanges; a wording treatment where we refer to the Affordable Care Act (ACA) as "Obamacare"; and lastly, a cost-calculator treatment that allows individuals to explore the likely cost of insurance based on their own characteristics. Among the uninsured, we find that the cost-calculator treatment, the risk treatment, and the mandate are most effective in increasing intention to purchase insurance. The cost-calculator and the risk treatment increase informedness among this population, but the cost-calculator (when paired with the savings treatment) is the only treatment that increases willingness to pay for insurance. We use the information on willingness to pay to construct sub-group price elasticities of demand to compare to previous work interested in the demand for health insurance. Overall, the results of this chapter highlight the importance of informational campaigns to increase awareness of the costs and benefits of health coverage, particularly after large changes such as those implemented by the ACA. My third chapter continues by looking at the changes that have been introduced as a result of the ACA. Specifically, it explores whether expanding access to government-provided insurance affects individuals' decisions regarding employment and overall hours of work. Recent findings have suggested that increasing access to health insurance outside of employment has a sizable, negative impact on labor force participation. Along these lines, the Congressional Budget Office predicted that the expansion of Medicaid and private health insurance will cause a 1.5 to 2% reduction in hours worked in the first ten years. Comparing states by whether they chose to expand Medicaid under reforms introduced by the ACA, I look at changes in the probability a childless adult receives Medicaid, as well as changes in this group's employment likelihood and hours of work. Using household survey data from the CPS monthly survey and ASEC Supplement, I confirm a marked increase in the percent of childless adults insured by Medicaid but find no statistically significant changes in employment outcomes. I compare these results to other estimates of "employment lock" in recent literature. These results, though imprecise, align with the findings in Chapter 1 which suggest that overall employment is not drastically affected by insurance demand.
Author: Marc N. Turenne
Publisher:
ISBN:
Category :
Languages : en
Pages : 366
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Author: David M. Cutler
Publisher:
ISBN:
Category : Employee fringe benefits
Languages : en
Pages : 56
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Book Description
Increases in the cost of providing health insurance must have some effect on labor markets, either in lower wages, changes in the composition of employment, or both. Despite a presumption that most of this effect will be in the form of lower wages, we document in this paper a significant effect on work hours as well. Using data from the CPS and the SIPP, we show that rising health insurance costs over the 1980s increased the hours worked of those with health insurance by up to 3 percent. We argue that this occurs because health insurance is a fixed cost, and as it becomes more expensive to provide, firms face an incentive to substitute hours per worker for the number of workers employed.
Author: Amy Finkelstein
Publisher: Columbia University Press
ISBN: 0231538685
Category : Medical
Languages : en
Pages : 161
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Book Description
Addressing the challenge of covering heath care expenses—while minimizing economic risks. Moral hazard—the tendency to change behavior when the cost of that behavior will be borne by others—is a particularly tricky question when considering health care. Kenneth J. Arrow’s seminal 1963 paper on this topic (included in this volume) was one of the first to explore the implication of moral hazard for health care, and Amy Finkelstein—recognized as one of the world’s foremost experts on the topic—here examines this issue in the context of contemporary American health care policy. Drawing on research from both the original RAND Health Insurance Experiment and her own research, including a 2008 Health Insurance Experiment in Oregon, Finkelstein presents compelling evidence that health insurance does indeed affect medical spending and encourages policy solutions that acknowledge and account for this. The volume also features commentaries and insights from other renowned economists, including an introduction by Joseph P. Newhouse that provides context for the discussion, a commentary from Jonathan Gruber that considers provider-side moral hazard, and reflections from Joseph E. Stiglitz and Kenneth J. Arrow. “Reads like a fireside chat among a group of distinguished, articulate health economists.” —Choice
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309168570
Category : Medical
Languages : en
Pages : 294
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Book Description
A Shared Destiny is the fourth in a series of six reports on the problems of uninsurance in the United States. This report examines how the quality, quantity, and scope of community health services can be adversely affected by having a large or growing uninsured population. It explores the overlapping financial and organizational basis of health services delivery to uninsured and insured populations, the effects of community uninsurance on access to health care locally, and the potential spillover effects on a community's economy and the health of its citizens. The committee believes it is both mistaken and dangerous to assume that the persistence of a sizable uninsured population in the United States harms only those who are uninsured.
Author: Alan B. Krueger
Publisher:
ISBN:
Category : Employee fringe benefits
Languages : en
Pages : 54
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