The Effect of the Affordable Care Act Preexisting Conditions Provision on Marriage (with Matt Hampton; 2019, Health Economics)
This paper investigates the effect of the Affordable Care Act preexisting conditions provision on marriage. The policy was implemented to prevent insurers from denying insurance coverage to individuals with preexisting health conditions. We test whether the implementation of the provision led to decreases in marriage among affected adults. We add to earlier work on how marital behavior is influenced by spousal health insurance and examine for the presence of “marriage lock,” a situation in which individuals remain married primarily for insurance. Using data from the Panel Study of Income Dynamics from 2009 to 2017 and estimating difference-in-differences models, we find that male household heads with preexisting conditions are 7.12 percentage points (8.9 percent) less likely to be married after the policy. Using information on insurance status prior to the policy change, we find significant reductions in marriage among individuals with preexisting conditions who were previously insured by spousal health insurance plans. The findings suggest that the inability to attain individual coverage and reliance on spousal insurance provided incentives to remain married before 2014.
This study examines the relationship between state-level Earned Income Tax Credit (EITC) laws in the U.S. on suicides. Following findings in previous work showing that the EITC is associated with lower depression rates and reduced number of risky biomarkers, I estimate the effects of state EITC generosity on suicide rates. Using data for the years 1996 to 2016, a period with 74 state-level EITC policy changes, I find that introducing a high state EITC rate reduces suicide rates for adults aged 25 or above by 3.91 percent. The results are consistent across four different measures of EITC generosity.
The Effects of Income on Health – New Evidence from the Earned Income Tax Credit (2019, Review of Economics of the Household)
This study examines the relationship between income and health by using an expansion of the Earned Income Tax Credit (EITC), which increased benefits to households with at least two children, as a source of exogenous variations of earnings. The paper adds to previous work by: (1) estimating treatment effects on the treated using simulated EITC benefits and longitudinal data; (2) testing whether health effects vary across the three different parts of the EITC schedule; (3) examining the role of food expenditures and health insurance as potential mechanisms. The study finds that income improves the likelihood of affected heads of households reporting to be in excellent or very good health by 6.9 to 8.9 percentage points. The effects are largest in the plateau phase of the EITC schedule, where previous researchers have identified pure income effects of the program. The results are robust to several additional specifications, including a semi-parametric DD model and specifications that account for the potential endogeneity of sample. When examining potential channels underlying the relationship between income and health, I find that affected household increase their food expenditures by 10.5 to 20.3 percent and are 1.52 percent more likely to have health insurance coverage.
Selected Working Papers
Pathways between Minimum Wages and Health: The Role of Health Insurance, Health Care Access, and Health Care Utilization (revise & resubmit)
This study contributes to recent work on the relationship between minimum wages and health by examining potential underlying mechanisms. Specifically, the roles of health insurance, health care access and utilization are explored. By analyzing Current Population Survey data for the years 1989 to 2009 and by estimating DD models, I find that higher minimum wages increase health insurance coverage, in particular individually purchased insurance, among low-educated individuals. By estimating data from the Behavioral Risk Factor Surveillance System for the same period, I furthermore provide evidence for improvements in health care access/affordability and increased health care utilization following minimum wage increases.
Safety Net against Hunger? The Effects of the Earned Income Tax Credit on Food Insecurity (under review)
This study examines the relationship between the Earned Income Tax Credit (EITC) and food insecurity. While previous work has established that the EITC provides health benefits, less is known about the underlying mechanisms through which this occurs. Using the 2009 EITC expansion, I estimate DD and DDD models to evaluate the role of food security. My analysis finds that the program expansion, which increased annual EITC benefits by $635 to $669, reduced the likelihood being food insecure by 7.0 to 11.4 percent. The results are robust to different sample selections and several alternative model specifications.