Exploring the Taxation of New York’s New Paid Family Medical Leave Benefit by Richard Barnes :: SSRN

January 2, 2019

This article examines the taxation of benefits received under New York’s new Paid Family Leave Act. The article argues that New York’s Paid Family Leave Act is unique when compared to similar provisions enacted in other states to date and that benefits paid under the tax are excluded from federal gross income by operation of Internal Revenue Code Sections 104 and 105. Additionally, the article contends that New York’s Department of Taxation and Finance’s Notice N-17-12 errs in concluding that amounts paid under the Act are includible in federal gross income. The article contends that insurance policies issued in compliance with the Act are “health insurance” and that income replacement benefits paid under the Act are paid for “sickness” as described in Code Sections 104 and 105.

via Exploring the Taxation of New York’s New Paid Family Medical Leave Benefit by Richard Barnes :: SSRN


AEI Event | E-cigarette regulation: Teens and trade-offs Remarks from Iowa Attorney General Tom Miller

February 19, 2019

E-cigarettes offer adult smokers who are unable or unwilling to give up nicotine a healthier option than traditional tobacco products. However, new evidence has pointed to a significant and unwanted rise in teenage vaping. Policymakers must decide how to best structure balanced policy that curtails youth access while ensuring adult choice. The future of smokers’ access to safer alternatives depends on such a resolution.At this event, Iowa Attorney General Tom Miller will offer remarks on e-cigarette policy, followed by a panel discussion with experts.

Source: E-cigarette regulation: Teens and trade-offs Remarks from Iowa Attorney General Tom Miller


Brookings/USC Event | Emerging policy solutions to surprise medical bills

February 19, 2019

Too often, patients are surprised to find a bill from an out-of-network provider involved in their treatment who they had no control in choosing. Studies suggest that roughly 1 in 5 emergency room visits and 1 in 10 elective inpatient procedures result in the potential for a surprise out-of-network bill, most commonly when patient seek care at an in-network hospital but end up treated by certain emergency department or ancillary physicians (such as anesthesiologists, radiologists, pathologists, or assistant surgeons) who are outside their insurer’s provider network, and financial consequences can be devastating.In recent years, many states have moved to address surprise billing and a few federal proposals are floating around Congress. While there is broad bipartisan agreement that a problem exists, a solution can sometimes prove elusive. On Wednesday, February 20, 2019, the USC-Brookings Schaeffer Initiative for Health Policy will present new analysis detailing policy approaches to eliminate surprise out-of-network billing and bring together policymakers and stakeholders to discuss how to craft a solution.This event will be live webcast.

Source: Register to watch “Emerging policy solutions to surprise medical bills”


AEI Event | Sense and severability: If one part of the Affordable Care Act is ruled unconstitutional, what is the proper remedy or resolution?

February 16, 2019

On December 14, a federal district court in Texas ruled that the current version of the Affordable Care Act’s (ACA) individual mandate was unconstitutional. This is a link to two panel discussions on the often-overlooked law of severability and what might happen to the rest of the ACA if that finding holds up on appeal.The first panel discussed the current state of severability, how consistently it is applied, and whether there are possible alternatives that could improve it. The second panel discussed how severability law should be applied properly as this case advances. If an appellate court upholds the district court decision on constitutional issues, it still must decide what to do next. The primary options including striking down only the individual mandate (full severability), severing other functionally linked ACA insurance regulation provisions (partial severability), and finding that the entire ACA cannot be sustained.

Source: Sense and severability: If one part of the Affordable Care Act is ruled unconstitutional, what is the proper remedy or resolution?


The unanswered questions of Medicare for All – AEI

February 16, 2019

The single-payer health insurance proposal known widely as Medicare for All (M4A) cannot be enacted without first answering certain questions. Foremost among these is whether the public would support shifting more than $32 trillion in M4A’s first 10 years from private health spending, over which consumers retain some discretion, to federal health spending, over which consumers do not. A related open question is whether the federal government can adequately finance this amount of spending without triggering significant adverse economic effects. Other unanswered questions include M4A’s effects on health providers, the prescription drug market, and private health insurance. M4A would add further to national health cost growth unless provider reimbursements are cut more sharply than lawmakers have been willing to do historically. Yet the consequences of enacting such payment cuts simultaneously with a substantial increase in health service demand are unpredictable.

Source: The unanswered questions of Medicare for All – AEI


The impact of financial incentives on health and health care: Evidence from a large wellness program – Einav – 2019 – Health Economics – Wiley Online Library

January 10, 2019

Workplace wellness programs have become increasingly common in the United States, although there is not yet consensus regarding the ability of such programs to improve employees’ health and reduce health care costs. In this paper, we study a program offered by a large U.S. employer that provides substantial financial incentives directly tied to employees’ health. The program has a high participation rate among eligible employees, around 80%, and we analyze the data on the first 4 years of the program, linked to health care claims. We document robust improvements in employee health and a correlation between certain health improvements and reductions in health care cost. Despite the latter association, we cannot find direct evidence causally linking program participation to reduced health care costs, although it seems plausible that such a relationship will arise over longer horizons.

via The impact of financial incentives on health and health care: Evidence from a large wellness program – Einav – 2019 – Health Economics – Wiley Online Library


SeaTE: Subjective ex ante Treatment Effect of Health on Retirement by Pamela Giustinelli, Matthew D. Shapiro :: SSRN

January 2, 2019

This paper develops an innovative approach to measuring the effect of health on retirement. The approach elicits subjective probabilities of working at specified time horizons fixing health level. Using a treatment-effect framework, within-individual differences in elicited probabilities of working given health yield individual-level estimates of the causal effect of health (the treatment) on working (the outcome). We call this effect the Subjective ex ante Treatment Effect (SeaTE). The paper then develops a dynamic programming framework for the SeaTE. This framework allows measurement of individual-level value functions that map directly into the dynamic programming model commonly used in structural microeconometric analysis of retirement. The paper analyzes conditional probabilities elicited in the Vanguard Research Initiative (VRI)—a survey of older Americans with positive assets. Among workers 58 and older, a shift from high to low health would on average reduce the odds of working by 28.5 percentage points at a two-year horizon and 25.7 percentage points at a four-year horizon. There is substantial variability across individuals around these average SeaTEs, so there is substantial heterogeneity in taste for work or returns to work. This heterogeneity would be normally unobservable and hard to disentangle from other determinants of retirement in data on realized labor supply decisions and health states. The paper’s approach can overcome the problem that estimates of the effect of health on labor supply based on behavioral (realizations) data can easily overstate the effect of health on retirement whenever less healthy workers tend to retire earlier for reasons other than health.

via SeaTE: Subjective ex ante Treatment Effect of Health on Retirement by Pamela Giustinelli, Matthew D. Shapiro :: SSRN


Hunger Pains? SNAP Timing, and Emergency Room Visits by Chad D. Cotti, John Gordanier, Orgul D. Ozturk :: SSRN

January 2, 2019

The impact of poor nutrition has been established as an important determinant of health. It has also been demonstrated that the single monthly treatment of SNAP benefits leaves meaningful nutritional deficiencies in recipient households during the final weeks of the benefits cycle. Further, health related behaviors have been documented to be altered on the date of food stamp receipt. This project exploits highly detailed and linked administrative data on health care utilization of food stamp recipients and randomized food stamp receipt dates to allow us to measure the impact of food stamp treatment days and the low nutritional periods created by the SNAP benefits cycle on the likelihood of emergency department (ER) utilization among the Medicaid population. Our main finding is that among SNAP receiving individuals in the ER on a particular day, the share that received benefits on that day is 3.5% lower than would be expected. This effect is present across all age groups, although the magnitude is smallest for young children. Further, we find that for individuals 55 and over, the share of ER visits that comes from individuals that are past the third week of their SNAP benefit month, i.e. received benefits more than 21 days ago, is 1.5% larger than would be expected. This suggests that these older individuals are more likely to visit the ER late in the SNAP benefit cycle, which is consistent with increased food insecurity as a possible mechanism linking the food stamp benefits cycle to emergency care utilization. We find no such effect for younger individuals.

via Hunger Pains? SNAP Timing, and Emergency Room Visits by Chad D. Cotti, John Gordanier, Orgul D. Ozturk :: SSRN