The Effect of Health Insurance on Crime Evidence from the Affordable Care Act Medicaid Expansion

January 13, 2018

Little evidence exists on the Affordable Care Act (ACA) on criminal behavior, a gap in the literature that this paper seeks to address. Using a one period static model of criminal behavior, I argue we should anticipate a decrease in time devoted to criminal activities in response to the expansion, since the availability of public health insurance not only has a pure negative income effect on crime but also raises the opportunity cost of crime. This prediction is particularly relevant for the ACA expansion, because it primarily affects childless adults, the population that is most likely to engage in criminal behavior. I validate this forecast using a difference-in-differences approach, estimating the expansion’s effects on a panel dataset of state- and county-level crime rates. My point estimates show that the ACA Medicaid expansion is negatively related to burglary, motor vehicle theft, criminal homicide, robbery, and aggravated assault. The value of this Medicaid expansion induced reduction in crime to expansion states is almost $10 billion per year.

via The Effect of Health Insurance on Crime Evidence from the Affordable Care Act Medicaid Expansion by Qiwei He :: SSRN


It’s About Time: Effects of the Affordable Care Act Dependent Coverage Mandate on Time Use

January 10, 2018

We examine how the Affordable Care Act’s dependent coverage mandate (DCM) affected young adults’ time allocation. Exploiting more accurate measures from the American Time Use Surveys, we find that the DCM reduced labor supply. The question then arises, what have these adults done with the extra time? Estimates suggest a reduction in job‐lock, as well as in the duration of the average doctor’s visit, including time spent waiting and receiving care. The latter effect is consistent with substitution from emergency‐department utilization toward more routine care. Estimates suggest that the extra time has gone into socializing, and into educational and job‐search activities.

via It’s About Time: Effects of the Affordable Care Act Dependent Coverage Mandate on Time Use by Greg Colman, Dhaval Dave :: SSRN


Employment Status and Health Characteristics of Adults With Expanded Medicaid Coverage in Michigan

December 14, 2017

The Affordable Care Act (ACA) expanded Medicaid coverage to approximately 11 million working-age adults. Critics have raised concerns about providing Medicaid to adults capable of working. Several states have proposed work requirements in Section 1115 Medicaid waivers.1,2 Although none were approved during the Obama administration, the Trump administration is willing to consider such provisions.3 Prior analyses4 estimated that half of adults eligible for ACA Medicaid expansion were employed, and 62% of nondisabled adults were working or in school. Although these national estimates of Medicaid-eligible individuals are valuable, less is known about the employment experience of actual enrollees in Medicaid expansion states and which health characteristics may keep them from working. Complementary state-level analyses are needed as individual states consider whether to propose work requirements. This study examined the demographic and health characteristics associated with the employment status of current Medicaid expansion enrollees in Michigan, which expanded Medicaid under a Section 1115 waiver to nonelderly adults with incomes at or below 133% of the federal poverty level who do not otherwise qualify for Medicaid or Medicare based on disability or other criteria.

via Characteristics of Adults With Expanded Medicaid Coverage in Michigan | Health Care Reform | JAMA Internal Medicine | The JAMA Network


It’s About Time: Effects of the Affordable Care Act Dependent Coverage Mandate on Time Use

December 8, 2017

We examine how the Affordable Care Act’s dependent coverage mandate (DCM) affected young adults’ time allocation. Exploiting more accurate measures from the American Time Use Surveys, we find that the DCM reduced labor supply. The question then arises, what have these adults done with the extra time? Estimates suggest a reduction in job‐lock, as well as in the duration of the average doctor’s visit, including time spent waiting and receiving care. The latter effect is consistent with substitution from emergency‐department utilization toward more routine care. Estimates suggest that the extra time has gone into socializing, and into educational and job‐search activities.

via It’s About Time: Effects of the Affordable Care Act Dependent Coverage Mandate on Time Use by Greg Colman, Dhaval Dave :: SSRN


Work Incentives of Medicaid Beneficiaries and the Role of Asset Testing

December 8, 2017

Should asset testing be used in means‐tested programs? Focusing on Medicaid, we show that in the asymmetric information environment, there is a positive role for asset testing. Our tool is a general equilibrium model with heterogeneous agents. We find that 23% of Medicaid enrollees do not work in order to be eligible. These distortions are costly: If Medicaid eligibility could be linked to (unobservable) productivity, this results in substantial welfare gains. We show that asset testing can achieve a similar outcome when asset limits are allowed to be different for workers and nonworkers.

via Work Incentives of Medicaid Beneficiaries and the Role of Asset Testing by Svetlana Pashchenko, Ponpoje Porapakkarm :: SSRN


Does Medicaid Generosity Affect Household Income?

December 8, 2017

Almost all recent literature on Medicaid and labor supply has used Affordable Care Act (ACA)- induced Medicaid eligibility expansions in various states as natural experiments. Estimated effects on employment and earnings differ widely due to differences in the scope of eligibility expansion across states. Using a Regression Kink Design (RKD) framework, this paper takes a uniquely different approach to the identification of the effect of Medicaid generosity on household income. Both state-level data and March CPS data from 1980–2013 suggest that generous federal funding of state-level Medicaid costs have a modest negative effect on household income. The negative impact of Medicaid generosity on household income is more pronounced at the lower end of the household income distribution and on the income and earnings of female heads.

via Does Medicaid Generosity Affect Household Income? by Anil Kumar :: SSRN


Cutting Obamacare Subsidies Would Benefit Poor, Says CBO | Economics21

August 18, 2017

The unsurprising part is CBO’s expectation that if CSR subsidies are withdrawn, sponsors of silver plans will hike premiums substantially.

The surprising part is that CBO found that not only would this generally not hurt low-income participants, it would on balance benefit them – especially older Americans below 400 percent of the poverty line.  The primary losers, under CBO’s analysis, would be federal taxpayers.  Add it all up, and terminating the CSR subsidies would paradoxically lead to a substantial increase in progressive income redistribution.

Source: Cutting Obamacare Subsidies Would Benefit Poor, Says CBO | Economics21