modeling skewness with the linear stochastic plateau model to determine optimal nitrogen rates accurate modeling of skewness is needed to increase the actuarial fairness of crop insurance we test day s conjecture that crop yield skewness becomes negative as nitrogen rates increase and determine how well a linear response stochastic plateau lrsp production function matches the pattern of observed skewness using four long term nitrogen experiments stillwater wheat is consistent with day s conjecture but the skewness for lahoma and altus wheat yields as well as altus cotton yields are not the lrsp assumes normal random effects and can explain only a small part of observed skewness so a new lrsp with skew normal random effects is introduced which comes closer to explaining the observed skewness and should increase the accuracy of nitrogen rate recommendations negative skewness reduced optimal nitrogen rates and positive skewness increased optimal nitrogen rates

government old age support and labor supply evidence from the old age assistance program many major government programs transfer resources to older people and implicitly or explicitly tax their labor in this paper we shed new light on the labor supply and welfare effects of such programs by investigating the old age assistance program oaa a means tested and state administered pension program created by the social security act of 1935 using newly available census data on the entire us population in 1940 we exploit the large differences in oaa programs across states to estimate the labor supply effects of oaa our estimates imply that oaa reduced the labor force participation rate among men aged 65 74 by 5 8 percentage points nearly half of its 1930 40 decline however both reduced form evidence and an estimated structural model of labor supply imply that the welfare cost to recipients of the high tax rates implicit in oaa s earnings test were small the evidence also suggests that social security could account for at least half of the large decline in late life work from 1940 to 1960

does medical malpractice law improve health care quality we assess the potential for medical liability forces to deter medical errors and improve health care treatment quality identifying liability s influence by drawing on variations in the manner by which states formulate the negligence standard facing physicians using hospital discharge records from the national hospital discharge survey and clinically validated quality metrics inspired by the agency for health care research and quality we find evidence suggesting that treatment quality may improve upon reforms that expect physicians to adhere to higher quality clinical standards we do not find evidence however suggesting that treatment quality may deteriorate following reforms to liability standards that arguably condone the delivery of lower quality care similarly we do not find evidence of deterioration in health care quality following remedy focused liability reforms such as caps on non economic damages awards

effects of universal health insurance on health care utilization and supply side responses evidence from japan abstract we investigate the effects of a massive expansion in health insurance coverage on health care utilization and supply side responses by focusing on universal health insurance introduced in japan in 1961 there are two major findings first health care utilization measured in terms of admissions inpatient days and outpatient visits to hospitals increased significantly second we also find a supply response but the size of the supply response differs across service types while the number of beds increases effects on the number of medical institutions physicians and nurses are either negligible or inconclusive our results suggest that countries planning a large expansion in health insurance coverage would need to generate sufficient financial resources to cover the surge in health care expenditures both in the short and long run our results also indicate that any slowdown in the supply side response may constrain the ability of the health care system to meet increased demand

the effect of safety net programs on food insecurity we investigate to what extent major safety net program benefits affect food insecurity in families we impute program eligibility and benefits in each state for 2001 2009 accounting for cross program eligibility rules we use simulated eligibility and benefits for a nationally representative sample as instruments for imputed eligibility and potential benefits among nonimmigrant low income single parent families 1 000 in potential cash or food benefits reduces the incidence of food insecurity by 1 1 percentage points on a base of 33 percent cash and food both reduce food insecurity the results highlight the importance of jointly considering a full range of safety net programs

input demand under yield and revenue insurance previous studies disagree on the effects of insurance on fertilizer application rates the effect of increased fertilizer on the probability of low yields primarily determines whether fertilizer and insurance are substitutes or complements we estimate conditional distributions of corn yields to determine if the technical relationship between yields and fertilizer supports the hypothesis that insurance increases optimal application rates our results indicate no support for this hypothesis at all nitrogen fertilizer rates and reasonable levels of risk aversion nitrogen fertilizer and insurance are substitutes suggesting that those who purchase insurance are likely to decrease nitrogen fertilizer applications

modeling conditional yield densities given the increasing interest in agricultural risk many have sought improved methods to characterize conditional crop yield densities while most have postulated the beta as a flexible alternative to the normal others have chosen nonparametric methods unfortunately yield data tends not to be sufficiently abundant to invalidate many reasonable parametric models this is problematic because conclusions from economic analyses which require estimated conditional yield densities tend not to be invariant to the modeling assumption we propose a semiparametric estimator that because of its theoretical properties and our simulation results enables one to empirically proceed with a higher degree of confidence copyright 2003 oxford university press

the family as the health producer when spouses are nash bargainers the grossman model is extended to a situation in which the family is regarded as the producer of individual health and spouses are nash bargainers the model has implications for the interaction between family structure income and the stocks of health capital and the bargaining strength of different family members the main insight is that the possibility of divorce affects the distribution of health capital between family members we analyse inter alia the impact on the distribution of health particularly regarding child health of changes in family policies related to the dissolution of the family

hips and hearts the variation in incentive effects of insurance across hospital procedures the separate identification of effects due to incentives selection and preference heterogeneity in insurance markets is the topic of much debate in this paper we investigate the presence and variation in moral hazard across health care procedures the key motivating hypothesis is the expectation of larger causal effects in the case of more discretionary procedures the empirical approach relies on an extremely rich and extensive dataset constructed by linking survey data to administrative data for hospital medical records using this approach we are able to provide credible evidence of large moral hazard effects but for elective surgeries only

the social content of macroeconomic policies abstract there is now widespread recognition of the need to integrate macroeconomic policy and social policy but the mainstream approach is one of adding on social policy we argue for a transformatory approach which would mainstream gender equitable social policy within macroeconomic policy we identify three interlinked biases which prevent this from happening deflationary bias male breadwinner bias and commodification bias we illustrate a transformatory approach with the example of the canadian alternative federal budget we argue that a social dialogue is necessary for the formulation of such alternatives

censored quantile instrumental variable estimates of the price elasticity of expenditure on medical care efforts to control medical care costs depend critically on how individuals respond to prices i estimate the price elasticity of expenditure on medical care using a censored quantile instrumental variable cqiv estimator cqiv allows estimates to vary across the conditional expenditure distribution relaxes traditional censored model assumptions and addresses endogeneity with an instrumental variable my instrumental variable strategy uses a family member s injury to induce variation in an individual s own price across the conditional deciles of the expenditure distribution i find elasticities that vary from 0 76 to 1 49 which are an order of magnitude larger than previous estimates

the rise of the states u s fiscal decentralization in the postwar period article i nfo article history one of the most dramatic changes in the fiscal federalism landscape during the postwar period has been the rapid growth in state budgets which almost tripled as a share of gdp and doubled as a share of government spending between 1952 and 2006 we argue that the greater role of states cannot be easily explained by changes in tiebout forces of fiscal competition such as mobility and voting patterns and are not accounted for by demographic or income trends rather we demonstrate that much of the growth in state budgets has been driven by changes in intergovernmental interactions restricted federal grants to states have increased and federal policy and legal constraints have also mandated or heavily incentivized state own source spending particularly in the areas of education health and public welfare these outside pressures moderate the forces of fiscal competition and must be taken into account when assessing the implications of observed revenue and spending patterns

impact of copula choice on the modeling of crop yield basis risk a number of problems in agricultural economics involve modeling joint distributions for which the assumption of multivariate normality may not be warranted yet very little work has been conducted evaluating competing methods for modeling joint dependence we develop a simulation framework to evaluate the bias and efficiency impacts of copula choice in the context of evaluating county to farm basis risk the results suggest significant differences in performance across various copulas and approaches the findings have important implications for risk analysis insurance and policy modeling problems in agriculture regarding the selection of method to model dependence among random variables

crop yield skewness under law of the minimum technology no satisfactory motivation has been forwarded in favor of any crop yield distribution including the normal this article explores the foundations of yield distributions for the law of the minimum resource constraint technology at the plot level of analysis with independent identical uniform resource availability distributions the yield skew is positive whereas it is negative whenever the distributions are normal simulations show how asymmetries in resource availabilities determine skewness it is suggested that a negative yield skew occurs whenever production is tightly controlled so that the left tails of some resources availabilities distributions are thin irrigation may increase yield skewness copyright 2009 oxford university press

are crop yields normally distributed the evidence for nonnormality of crop yields is reassessed three methodological problems are identified in typical yield distribution analyses i misspecification of the nonrandom components of yield distributions ii missreporting of statistical significance and iii use of aggregate timeseries ats data to represent farm level yield distributions one or more of these problems infect virtually all evidence against normality to date the positive contribution of the article is a set of principles that must be followed in any valid investigation of yield normality

health insurance and retirement of married couples summary most health insurance in the usa is provided by employers until eligibility for public health insurance medicare begins at age 65 retiring before 65 exposes workers who lack retiree health insurance coverage to the risk of catastrophic medical expenditure we solve and estimate a dynamic model of the employment behavior of older married couples that includes risky medical expenditure and health insurance parameter estimates imply that the risk reducing feature of health insurance can account for about half of the observed association between retiree health insurance and employment for married men but can account for only one tenth of the much larger observed association for married women policy simulations imply very small effects on employment of changing the age of eligibility for medicare from 65 to 67 copyright 2006 john wiley sons ltd

moral hazard in health insurance do dynamic incentives matter using data from employer provided health insurance and medicare part d we investigate whether healthcare utilization responds to the dynamic incentives created by the nonlinear nature of health insurance contracts we exploit the fact that because annual coverage usually resets every january individuals who join a plan later in the year face the same initial spot price of healthcare but a higher expected end of year future price we find a statistically significant response of initial utilization to the future price rejecting the null that individuals respond only to the spot price we discuss implications for analysis of moral hazard in health insurance

crop insurance valuation under alternative yield distributions considerable disagreement exists about the most appropriate characterization of farm level yield distributions yet the economic importance of alternative yield distribution specifications on crop insurance valuation has not been well documented the results of this study demonstrate that large differences in expected payouts from popular crop insurance products can arise solely from the parameterization chosen to represent yield distributions the results suggest that the frequently unexamined yield distribution specification may lead to economically significant errors in crop insurance policy rating and assessment of expected payouts from policies

the value of medicaid interpreting results from the oregon health insurance experiment we develop frameworks for welfare analysis of medicaid and apply them to the oregon health insurance experiment across different approaches we estimate low income uninsured adults willingness to

government decision making and the incidence of federal mandates abstract this paper analyzes the effects of federally mandated program changes on state spending and revenues incorporating and evaluating the predictive value of several common theories of the state decision making process using several sources of exogenous increases in public medical spending i estimate that the entire state portion of the burden of mandated spending is borne by decreases in other public welfare spending while federal mandates may influence the composition of benefits at the state level it is much more difficult for them to change the total level of state transfers comparison of state reactions to different shocks suggests that these reductions are due in part to the substitutability of programs in the voter utility function but also in part to the stickiness of spending within budget categories states with greater racial differences between recipients and voters and states with less generous neighbors reduce other public welfare spending by even more alleviating the burden the medical expansions imposed on their taxpayers mandates may thus serve only to increase inequality across states

nonparametric estimation of crop yield distributions implications for rating group risk crop insurance contracts we use nonparametric density estimation procedures to evaluate county level crop yield distributions implications for rating area yield crop insurance contracts are discussed the procedures developed are used to measure yield risk and calculate insurance premium rates for wheat and barley in the 1995 96 group risk program

assessing health reform in colombia from theory to practice in 1993 colombia implemented an ambitious health reform its key component was a radical transformation of the manner in which health care provision particularly care that was directed toward lower income individuals was financed we first describe the institutional aspects of the reform and discuss the difficulties that transferring funding from supply to demand side channels entailed we emphasize that while the reform substantially increased health insurance coverage progress was slower than forecast and entailed a substantial increase in expenditure the second part of the paper evaluates the impact of the subsidized regime that the reform introduced to benefit the low income population we explore the subsidized regime s effect on health outcomes measured through self reports on health status and on the number of days in which individuals were unable to perform regular activities the use of medical services household consumption of nonhealth goods and labor force participation

reforms with a female face gender liberalization and economic policy in andhra pradesh india summary the state of andhra pradesh india provides a case study of a liberalization program with an emphasis on women s empowerment based on the state budget data and fieldwork data from two villages this paper investigates the content of this policy regime to argue that women s empowerment policies were ultimately constrained by the policy context of liberalization the state lowered shares of expenditure upon social reproduction and the substantive content of women s empowerment policy was reduced to a thrift and micro credit program fieldwork data indicate the latter lacks administrative support and relies upon the expenditure of time and resources by participants themselves re emphasizing class and caste inequalities among women and undermining the broader project of empowerment

tails curtailed accounting for nonlinear dependence in pricing margin insurance for dairy farmers livestock gross margin insurance for dairy cattle lgm dairy is a risk management tool for protecting milk income over feed cost margins in this article we examine the assumptions underpinning the method used to determine lgm dairy premiums analysis of the milk feed dependence structure is conducted using copula methods a rich set of tools that allow modelers to capture nonlinearities in dependence among variables of interest we find a significant relationship between milk and feed prices that increases with time to maturity and severity of negative price shocks extremal or tail dependence is the propensity of dependence to concentrate in the tails of a distribution a common theme in financial and actuarial applications and in agricultural crop revenue insurance is that tail dependence increases the risk to the underwriter and results in higher insurance premiums we present to our knowledge the first case in which tail dependence may actually reduce actuarially fair premiums for an agricultural risk insurance product we examine hedging effectiveness with lgm dairy and show that even in the absence of basis or production risk hedging horizon plays an important role in the ability of this tool to smooth farm income over feed cost margins over time rating methodology that accounts for tail dependence between milk and feed prices extends the optimal hedging horizon and increases hedging effectiveness of the lgm dairy program

public insurance and child hospitalizations access and efficiency effects abstract the 1983 1996 period saw enormous expansions in access to public health insurance for low income children we explore the impact of these expansions on child hospitalizations while greater access to inpatient care may increase hospital utilization improved efficiency of care for children who are also newly eligible for primary care could lower hospitalization rates we use a large sample of child discharges from the national hospital discharge survey nhds to assess the net impact of medicaid expansions on hospitalizations during this period we find that total hospitalizations increased significantly with each 10 percentage point rise in eligibility leading to an 8 4 increase in hospitalizations thus the access effect strongly outweighs any efficiency effect produced by expanded coverage however we find some support for an efficiency effect the increase in hospitalizations for unavoidable conditions is much larger than that for avoidable conditions that are most sensitive to outpatient care indeed the increase in avoidable hospitalizations is less than half that of unavoidable hospitalizations and it is not statistically significant we also find that expanded medicaid eligibility reduced the average length of stay but increased the utilization of inpatient procedures so that the net impact on total costs per stay is ambiguous

estimating heterogeneous takeup and crowd out responses to existing medicaid income limits and their nonmarginal expansions we use a switching probit model and the income limit based structure of medicaid eligibility for children to estimate treatment effects of nonmarginal medicaid expansions on medicaid takeup private insurance coverage and crowd out as well as crowd out for those eligible for medicaid under rules already in place many of these estimates are not found in existing work on public insurance and cannot be calculated with the linear probability model used by previous work in this literature we provide an estimation approach that is straightforward to implement yet yields precise treatment effects

does medicare save lives health insurance characteristics shift at age 65 as most people become eligible for medicare we measure the impacts of these changes on patients who are admitted to hospitals through emergency departments for conditions with similar admission rates on weekdays and weekends the age profiles of admissions and comorbidities for these patients are smooth at age 65 suggesting that the severity of illness is similar on either side of the medicare threshold in contrast the number of procedures performed in hospitals and total list charges exhibit small but statistically significant discontinuities implying that patients over 65 receive more services we estimate a nearly 1 percentage point drop in 7 day mortality for patients at age 65 equivalent to a 20 reduction in deaths for this severely ill patient group the mortality gap persists for at least 9 months after admission

incentives for the identification and treatment of children with disabilities the supplemental security income program abstract this paper examines how supplemental security income ssi benefit availability and generosity affect the probability that families identify health problems in their children and move onto the ssi rolls first i observe that a liberalization of ssi eligibility in 1990 was followed by a substantial re evaluation of the health status of low income children by their parents then i find that increases in ssi benefits raise the likelihood that a family identifies a chronic impairment in their child my results indicate that cash assistance targeted on children with disabilities promotes the detection and treatment of medical problems in low income children

compensating differentials and income taxes are the wages of dangerous jobs more responsive to tax changes than the wages of safe jobs income taxes distort the relationship between wages and nontaxable amenities when the marginal tax rate increases amenities become more valuable as the compensating differential for low amenity jobs is taxed away while there is evidence that the provision of amenities responds to taxes the literature has ignored the consequences for job characteristics which cannot fully adjust this paper compares the wage response of dangerous jobs to the wage response of safe jobs when tax rates increase we should see the pretax compensating differential for on the job risk increase empirically i find large differences in the wage response of jobs based on their riskiness

health insurance and mortality experimental evidence from taxpayer outreach we evaluate a randomized pilot study in which the irs sent informational letters to 3 9 million taxpayers who paid a tax penalty for lacking health insurance coverage under the affordable care act drawing on administrative data we study the effect of the intervention on taxpayers subsequent health insurance enrollment and mortality we find the intervention led to increased coverage in the two years following treatment and that this additional coverage reduced mortality among middle aged adults over the same time period our results provide the first experimental evidence that health insurance reduces mortality

budgetary and producer welfare effects of revenue insurance legislation passed in 1996 changed the way the u s federal government acts to reduce risks faced by u s crop products the authors compare the new alternative forms of revenue insurance to the 1990 deficiency payment program and to a no program alternative they estimate the effects of the alternative polices on the acreage allocations of a representative farm on the expected government cost and on producer welfare simulation results indicate that a revenue insurance scheme that guarantees 75 percent of expected revenue to risk averse produced could provide approximately the same level of benefits as the 1990 program at as little as one fourth the cost

incentivizing better quality of care the role of medicaid and competition in the nursing home industry this paper develops a model of the nursing home industry to investigate the quality effects of policies that either raise regulated reimbursement rates or increase local competition using data from pennsylvania i estimate the parameters of the model the findings indicate that nursing homes increase the quality of care measured by the number of skilled nurses per resident by 8 7 following a universal 10 increase in medicaid reimbursement rates in contrast i find that pro competitive policies lead to only small increases in skilled nurse staffing ratios suggesting that medicaid increases are more cost effective in raising the quality of care

disability insurance rejection rates and the labor supply of older workers abstract we investigate the effects of trying to mitigate moral hazard in the disability insurance di program by raising the stringency of the screening process for applicants we do so by studying a dramatic increase in rejection rates for the di program in the late 1970s which varied substantially across the us states we find that each 10 rise in denial rates led to a statistically significant 2 8 fall in labor force non participation among 45 64 year old males we also find that the denial rate increases effectively targeted their incentive effects to more able individuals according to an anthropometric measure of disability

the impact of medicaid insurance coverage on dental service use abstract the new comprehensive health reform beginning in 2014 will require medicaid to expand all elements of coverage to individuals with incomes up to 133 percent of the federal poverty line with millions more individuals gaining eligibility for adult medicaid dental benefits generating an unbiased estimate of the elasticity of demand for dental services is critical the causal relationship between access to adult medicaid dental benefits and usage of dental services for low income adults is estimated using difference in differences estimation procedures to exploit the state level variation in adult medicaid dental benefits results suggest that adult medicaid dental benefits increase the probability of a dental visit within 12 months by 16 4 22 percent a variety of robustness checks are invoked to confirm the finding

vocational training programs and youth labor market outcomes evidence from nepal abstract lack of skills is arguably one of the most important determinants of high levels of unemployment and poverty in response policymakers often initiate vocational training programs in effort to enhance skill formation among the youth using a regression discontinuity design we examine a large youth training intervention in nepal we find twelve months after the start of the training program that the intervention generated an increase in non farm employment of 10 percentage points itt estimates and up to 31 percentage points for program compliers late estimates we also detect sizeable gains in monthly earnings women who start self employment activities inside their homes largely drive these impacts we argue that low baseline educational levels and non farm employment levels and nepal s social and cultural norms towards women drive our large program impacts our results suggest that the program enables otherwise underemployed women to earn an income while staying at home close to household errands and in line with the socio cultural norms that prevent them from taking up employment outside the house

the impact of health care reform on hospital and preventive care evidence from massachusetts in april 2006 massachusetts passed legislation aimed at achieving near universal health insurance coverage the key features of this legislation were a model for national health reform passed in march 2010 the reform gives us a novel opportunity to examine the impact of expansion to near universal coverage state wide among hospital discharges in massachusetts we find that the reform decreased uninsurance by 36 relative to its initial level and to other states reform affected utilization by decreasing length of stay the number of inpatient admissions originating from the emergency room and preventable admissions at the same time hospital cost growth did not increase

socio economic status and child health does public health insurance narrow the drawing on evidence from the u s this paper examines the effects of public health insurance on children recent expansions of american public health insurance programs to previously ineligible children have created a great deal of variation that can be used to identify their effects results indicate that providing public insurance to poor children narrows socio economic gaps in utilization and health among children however inefficiencies and inequities in the allocation of health care remain which suggests that universality and outreach programs are also important components of the public health systems common in europe

long term impacts of childhood medicaid expansions on outcomes in adulthood we use administrative data from the internal revenue service to examine long term impacts of childhood medicaid eligibility expansions on outcomes in adulthood at each age from 19 to 28 greater medicaid eligibility increases college enrolment and decreases fertility especially through age 21 starting at age 23 females have higher contemporaneous wage income although male increases are imprecise together both genders have lower mortality these adults collect less from the earned income tax credit and pay more in taxes cumulatively from ages 19 to 28 at a 3 discount rate the federal government recoups 58 cents of each dollar of its investment in childhood medicaid

the equilibrium impact of unemployment insurance on unemployment evidence from a non linear policy rule abstract we estimate the macro effect of an increase in the generosity of unemployment insurance ui on unemployment in sweden using regional data the national ui benefit formula features a benefit ceiling and a statutory replacement rate and does not take regional wage differentials into account changes in the national rules are useful for identification since a change in the benefit ceiling for example has a greater impact on ui generosity in a high wage region than in a low wage region because a greater fraction of the workforce will be affected by the benefit ceiling in the high wage region we implement this identification strategy using data for the swedish municipalities over the time period 1992 2014 our estimates suggest that the macro elasticity of an increase in ui on unemployment is around 3 this is twice as large as the corresponding micro elasticity which we estimate to 1 4 1 5 using data from the same time period

nonparametric estimation of crop insurance rates revisited with the crop insurance program becoming the cornerstone of u s agricultural policy recovering accurate rates is of paramount interest lack of yield data presents by far the most fundamental obstacle to recovery of accurate rates thisarticle employsnew methodology to estimate conditional yield densities and derive the insurance rates in our application we find the nonparametric kernel density estimator requires an additional twenty six years of yield data to estimate the shape of the conditional yield dens itiesasaccurately asthe recently developed empirical bayesnonparametric kernel density estimator such methodological improvements can significantly aid in ameliorating the data problem recovering accurate premium ratesis paramount to the actuarial soundness of the crop insurance program a program which hasgained prominence in the overall u s agricultural policy agenda the 1996 federal agricultural improvement and reform fair act signaled a new policy environment under which farmerswould be s to market forces under this policy regime crop insurance remains in some respects one of the only government subsidized income stabilizing mechanisms available to agricultural producers in addition it appears that current political forcesare in the proces sof fashioning crop insurance as the cornerstone of u s agricultural policy consider the 1999 state of the union address in which the president stated

investigating the performance of different estimation techniques for crop yield data analysis in crop insurance applications we investigate the performance of the ordinary least squares ols m mm and the theil sen ts estimator for crop yield data analysis in crop insurance applications using monte carlo simulations more specifically the performance is assessed with respect to trend estimation prediction of future yield levels and the estimation of expected indemnity payments in agreement with earlier findings other estimators are found to be superior to ols in simple regression problems if yield distributions are outlier contaminated and heteroscedastic while this conclusion is also valid for subsequent applications such as yield prediction and the estimation of expected indemnity payments the difference between the considered estimators becomes less distinct for these applications we find particularly the m estimator to be a good compromise between high breakdown very robust estimators and the very efficient ols estimator because no regression technique dominates all others in all applications and scenarios for error term distributions our results underline that the choice of the estimation technique should be dependent on the purpose of the crop yield data analysis however alternative estimators such as m mm and ts estimator can reduce and bound the risk of unreliable or inefficient crop yield data analysis in crop insurance applications

the effects of access to health insurance evidence from a regression discontinuity design in peru in many countries large parts of the population do not have access to health insurance peru has made an effort to change this in the early 2000s the institutional setup gives rise to the rare opportunity to study the effects of health insurance coverage exploiting a sharp regression discontinuity design we find large effects on utilization that are most pronounced for the provision of curative care individuals seeing a doctor leads to increased awareness about health problems and generates a potentially desirable form of supplier induced demand they decide to pay themselves for services that are in short supply

health insurance subsidies and deductible choice evidence from regional variation in subsidy schemes the extent to which premium subsidies can influence health insurance choices is an open question in this paper we explore the regional variation in subsidy schemes in switzerland designed as either in kind or cash transfers to study their impact on the choice of health insurance deductibles using health survey data and a difference in differences methodology we find that in kind transfers increase the likelihood of choosing a low deductible plan by approximately 4 percentage points or 7 our results indicate that the response to in kind transfers is strongest among women middle aged and unmarried individuals which we explain by differences in risk taking behavior health status financial constraints health insurance and financial literacy we discuss our results in the light of potential extra marginal effects on the demand for health care services which are however not supported by our data

the integration of child tax credits and welfare evidence from the national child benefit program abstract in 1998 the canadian government introduced a new child tax credit the innovation in the program was its integration with social assistance welfare some provinces agreed to subtract the new federally paid benefits from provincially paid social assistance partially lowering the welfare wall other provinces did not integrate benefits providing a quasi experimental framework for estimation we find large changes in social assistance take up and employment in provinces that provided the labour market incentives to do so in our sample the integration of benefits can account for between 19 and 27 of the decline in social assistance receipt between 1997 and 2000

estimating the effect of financial aid offers on college enrollment a regression discontinuity approach an important problem faced by colleges and universities that of evaluating the effect of their financial aid offers on student enrollment decisions is complicated by the likely endogeneity of the aid offer variable in a student enrollment equation this article shows how discontinuities in an east coast college s aid assignment rule can be exploited to obtain credible estimates of the aid effect without having to rely on arbitrary exclusion restrictions and functional form assumptions semiparametric estimates based on a regression discontinuity rd approach affirm the importance of financial aid as an effective instrument in competing with other colleges for students

the effect of child health insurance access on schooling evidence from public insurance expansions although a sizable literature analyzes the effects of public health insurance programs on short run health outcomes little prior work has examined their long term effects we examine the effects of public insurance expansions among children in the 1980s and 1990s on their future educational attainment we find that expanding health insurance coverage for low income children increases the rate of high school and college completion these estimates are robust to only using federal medicaid expansions and mostly are due to expansions that occur when the children are not newborns our results indicate that the long run benefits of public health insurance are substantial

will extending medicaid to two parent families encourage marriage several welfare programs in the united states restrict eligibility to single parent families this paper asks whether eliminating this restriction for medicaid encourages marriage i identify medicaid s effect through a series of health insurance reforms that were passed in the 1980s and 1990s targeting young children these reforms were associated with an increase in the probability of marriage of 1 7 percentage points while the expansions offered some incentives to become married they also created other incentives to become divorced known as the independence effect after controlling for the outflows from marriage due to the independence effect the estimated effect increases by 10 percent

health insurance coverage and the macroeconomy this paper investigates the relationship between the macroeconomy and health insurance coverage for non elderly americans we find that for men state unemployment rate is positively correlated with the probability of health insurance coverage in general and through an employer in particular and that these correlations are only partly explained by changes in employment status in contrast the insurance coverage of women and children appears to be insulated from fluctuations in the unemployment rate by public health insurance programs like medicaid and state children s health insurance program schip we estimate that 984 000 americans nearly all of whom were adult men lost health insurance due to macroeconomic conditions alone during the 2001 recession

health insurance eligibility utilization of medical care and child health two economists applied data from the current population survey and the national health interview survey and state level data on child mortality to a simulation model of utilization of medical care that varies only with the states legislative environment to examine the utilization of medical care and health effects of medicaid eligibility on low income children the models took into consideration the recent expansions of medicaid to low income children 38 of those ineligible for medicaid in 1984 who became eligible due to changes during 1984 1992 were uninsured between 1984 and 1992 expansions of the medicaid program increased the proportion of children eligible for medicaid almost two fold 16 1 vs 31 2 yet coverage rates were always lower than eligibility rates 13 2 vs 16 1 in 1984 and 20 3 vs 31 2 in 1992 and the increase in coverage rates was only about 50 of the increase in eligibility rates during 1984 1992 the probability that a child was eligible for medicaid increased the probability of health insurance coverage by 29 77 when the model considered bias in variables e g a recession in a state the take up rate was only 22 73 nevertheless medicaid markedly increased use of medical care for example eligibility for medicaid increased the likelihood of making a visit to a physicians office in the last two weeks by about 50 it also increased the probability of a child visiting the hospital suggesting inefficiency in the way that providers deliver care to medicaid enrollees medicaid eligibility had a significant effect on reducing child mortality the 15 1 percentage point increase in eligibility during 1984 1992 reduced child mortality by 4 5 when the researchers examined parent assessed subjective health measures medicaid eligibility had no effect on child health medicaid eligibility reduced race and education based disparities in the number of visits and racial differences in mortality yet it may actually intensify current disparities in health care delivery site

u s states the medicaid program and tax smoothing this paper tests the tax smoothing theory by focusing on its implication that a change in permanent government spending should result in an equal sized change in the tax rate the effect of medicaid a state administered federal and state funded medical insurance program for the poor on state tax rates is investigated the medicaid program provides a natural experiment for this test as states are required to cover certain groups in order to receive federal matching money additionally during the 1980s a series of federal mandates greatly increased state medicaid expenditures two stage least squares is used on a panel of u s states 1978 1994 to test whether changes in permanent state medicaid expenditures resulted in equal sized tax rate changes tax smoothing as a positive theory of state government behavior is rejected additionally it is found that this rejection cannot be attributed to the stringency of balanced budget rules