Health Insurance Expansions and Provider Behavior: Evidence from Substance Use Disorder Providers by Catherine Maclean, Ioana Popovici, Elisheva Stern :: SSRN

February 13, 2017

We examine how substance use disorder (SUD) treatment providers respond to private health insurance expansions induced by state equal coverage (‘parity’) laws for SUD treatment. We use data on the near universe of specialty SUD treatment providers in the United States between 1997 and 2010 in an event study analysis. During this period, 18 states implemented parity laws. Following the passage of a state parity law we find that providers are less likely to participate in public markets, are less likely to provide charity care, increase the quantity of healthcare provided, and become more selective of the type of patients they are willing to admit.

Source: Health Insurance Expansions and Provider Behavior: Evidence from Substance Use Disorder Providers by Catherine Maclean, Ioana Popovici, Elisheva Stern :: SSRN


Maternity and Family Leave Policy by Maya Rossin-Slater :: SSRN

February 8, 2017

Maternity and family leave policies enable mothers to take time off work to prepare for and recover from childbirth and to care for their new children. While there is substantial variation in the details of these policies around the world, the existing research yields the following general conclusions. First, despite important barriers to the take-up of leave, both the implementation of new programs and extensions of existing ones increase leave-taking rates among new parents. Second, leave entitlements less than one year in length can improve job continuity for women and increase their employment rates several years after childbirth; longer leaves can negatively influence women’s earnings, employment, and career advancement. Third, extensions in existing paid leave policies have no impact on measures of child well-being, but the introduction of short paid and unpaid leave programs can improve children’s short- and long-term outcomes. Fourth, while more research is needed, the current evidence shows minimal impacts of existing U.S. state-level programs on employer-level outcomes such as employee productivity, morale, profitability, turnover rates, or the total wage bill.

Source: Maternity and Family Leave Policy by Maya Rossin-Slater :: SSRN


Is Assisted Procreation an LGBT Right? by Michael Boucai :: SSRN

February 7, 2017

A movement long identified with the notion that “love makes a family” today flirts dangerously with the dogma that “blood is thicker than water.” Biogeneticism, an ideology that favors biological modes of kinship and genetic conceptions of identity, informs many LGBT individuals’ choices about why and how to have children. In turn this ideology marks two troubling features of political efforts to facilitate LGBT parenthood: first, the markedly different understandings of equality — full versus formal, lived versus legal — that guide movement approaches to assisted procreation and adoption, respectively; and second, invocations of a fundamental “right to procreate” that valorize reproduction, idealize a biological model of parenthood, and threaten to entrench biogenetic bias in family law and constitutional doctrine.

Source: Is Assisted Procreation an LGBT Right? by Michael Boucai :: SSRN


Anonymity, Autonomy, and the Collection of Personal Data: Measuring the Privacy Impact of Google’s 2012 Privacy Policy Change by James C. Cooper :: SSRN

February 7, 2017

One of the most vexing problems in privacy policy is identifying consumer harm from unwanted observation; because it is highly subjective and is likely to vary greatly throughout the population, it doesn’t lend itself to easy measurement. Yet, these types of situations increasingly are the focal point of privacy policy discussions. The primary approach to attempt to quantify subjective harms has been to measure consumers’ willingness to exchange personal data for money in an experimental setting. This study takes a different tack, using field data to measure actual consumer response to a real-world reduction in the anonymity of online search. In March 2012, Google began to combine user information across platforms. To the extent that Google’s policy change reduced the anonymity associated with Google search, it may have reduced incentives to search sensitive or topics. Using a difference-in-difference estimator with top non-sensitive search terms as the control group, the results suggest that there was a small and short-term reduction in the Google Trends scores for sensitive search. There is no measured difference in reaction between high- and low-privacy demand states. Overall, the results indicate that any consumer welfare loss from Google’s policy change was small, and likely swamped by the demand-increasing impact of customization made possible from the cross-platform data sharing. That there is no measurable long-term substitution out of sensitive search may reflect the privacy advantages of searching for sensitive information on Google versus seeking the same information in an interpersonal setting. These findings suggest that privacy policy changes that are publicized should be treated like ordinary price changes — causing marginal consumers to exit and reducing consumer surplus for those who remain — not opportunities for regulatory intervention.

Source: Anonymity, Autonomy, and the Collection of Personal Data: Measuring the Privacy Impact of Google’s 2012 Privacy Policy Change by James C. Cooper :: SSRN


Consumer Financial Protection in Health Care by Erin C. Fuse Brown :: SSRN

February 6, 2017

There are inadequate consumer protections from harmful medical billing practices that result in unavoidable, unexpected, and often financially devastating medical bills. The problem stems from increasing cost shifting to patients underway in American health care and the inordinate complexity that makes health care transactions nearly impossible for consumers to navigate. A particularly outrageous exemplar is the phenomenon of surprise medical bills, which refers to unanticipated and involuntary out-of-network bills in emergencies or from out-of-network providers at in-network facilities. Other damaging medical billing practices also include the opaque and a la carte nature of medical bills, epitomized by added “facility fees,” as well as harsh medical debt collection and credit reporting practices. The impetus of this article was driven by the simple questions: are these harmful health care billing practices legal? And if so, what can be done to protect patients as consumers? The questions are simple but the answers are not. This article canvasses a growing body of financial protections under federal and state law for health care consumers and concludes that, notwithstanding these significant efforts, consumer financial protections are inadequate for most health care consumers in this country. The article sets forth a model set of policy reforms that build upon state reforms to protect health care consumers. The biggest gaps in protection, however, are structural ― most states have not adopted robust health care consumer financial protections, and even if many more states did, ERISA preempts many state efforts to protect health care consumers for the large and growing number of consumers insured by self-funded employer health plans. Despite salutary state innovation in the area of patient financial protection, a growing ERISA vacuum means a federal solution is necessary to protect all health care consumers from medical-billing abuses.

Source: Consumer Financial Protection in Health Care by Erin C. Fuse Brown :: SSRN


Estimating the Employment Effects of Recent Minimum Wage Changes: Early Evidence, an Interpretative Framework, and a Pre-Commitment to Future Analysis by Jeffrey P. Clemens, Michael R. Strain :: SSRN

February 2, 2017

This paper presents early evidence on the employment effects of state minimum wage increases enacted between January 2013 and January 2015, and offers an interpretative framework to understand why it is of interest to study recent changes in isolation. Given the ongoing transitions of many states’ minimum wage rates, we also set the stage for a pre-committed analysis of the minimum wage changes scheduled for coming years. Through 2015, we estimate that employment among young adults and young individuals with less than a completed high school education expanded modestly less quickly in states that enacted one-time or multi-phase statutory minimum wage increases than in states that enacted no minimum wage increases. Across the specifications we implement and the samples we analyze, many of our estimates are statistically indistinguishable from zero. Data on the longer-run effects of this period’s minimum wage changes will be essential for more fully assessing these changes’ effects and for drawing strong conclusions regarding how minimum wage increases affect employment in this decade’s institutional and economic environment. As data become available for the full 2016 through 2019 calendar years, we will execute and report the results of analyses that follow the road map this paper develops.

Source: Estimating the Employment Effects of Recent Minimum Wage Changes: Early Evidence, an Interpretative Framework, and a Pre-Commitment to Future Analysis by Jeffrey P. Clemens, Michael R. Strain :: SSRN


Stopping Surprise Medical Bills: Federal Action Is Needed

February 1, 2017

Two recent nationwide studies, published in Health Affairs and The New England Journal of Medicine, both found that 20 percent of emergency department visits and resulting admissions at in-network facilities involved an out-of-network physician. The Health Affairs study conducted by researchers at the Federal Trade Commission, corroborated by other recent surveys, also highlights the problem of balance billing beyond only emergency physicians. Specifically, the Health Affairs authors found that 9 percent of elective inpatient care at an in-network facility with an in-network lead physician involved an out-of-network ancillary provider, and thus could have led to a surprise medical bill. Additionally, 51 percent of all ambulance rides in their data (primarily from large employer plans) were out of network.

Source: Stopping Surprise Medical Bills: Federal Action Is Needed