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Education

Doctor of Philosophy, University of Alabama, 2018

Discipline: Economics

Dissertation: Essays on Attention Deficit Hyperactivity Disorder

Bachelor of Science, Middle Tennessee State University, 2011

Major: Economics, Minor: Mathematics

Honors Thesis: Impacts of the Financial Crisis on Household Wealth

Vitae

Research Interests

Health Economics, Labor Economics, Public Economics, Public Policy

Publications

"Labor Mobility and the Affordable Care Act: Heterogeneous Impacts of the Preexisting Conditions Provision" (with Laura Connolly and Otto Lenhart) Journal of Policy Analysis and Management , 2024, 43.1, 157-191.

The Patient Protection and Affordable Care Act (ACA) preexisting conditions provision ensures that insurance companies can no longer deny coverage, charge higher premiums, or exclude coverage due to a preexisting health condition. In this paper, we evaluate the impact of the provision on labor mobility. We use data from the Panel Study of Income Dynamics for years 2009 through 2019 and estimate difference-in-differences models to determine whether the provision improved labor mobility for individuals with chronic conditions. While females respond along the extensive margin by being less likely to work, males experience broader labor mobility improvements. Men are more likely to start a new job, become employed in a different industry, and move to a different state in the post-policy period. Labor mobility improvements are largest among males with household incomes greater than 138 percent of the federal poverty level, males ages 35-49, and males with conditions first diagnosed more than 10 years ago. Last, we show that the policy improved access to health insurance coverage and reduced the likelihood that health impacts the amount or type of work, which ultimately increased labor market flexibility. Our results highlight the heterogeneous impacts of the provision on different subgroups of the population.

"Minimum Wages, Retirement Timing, and Labor Supply" (with Evan Totty)

Journal of Public Economics, 2023, 224, 104924.

Link to Census Bureau working paper

Media Coverage: Economic Policy Institute; Forbes; Market Watch; Clarksville Online

We find that minimum wage increases lead to increased employment for low-wage, retirement-age individuals using survey data linked to decades of individual-level IRS and SSA data. Own-wage elasticity estimates of the employment effect are larger than normal for the minimum wage literature but are consistent with recent evidence on labor supply effects of minimum wages and life-cycle models of labor supply. We also find evidence of delayed permanent employment exit and delayed retirement benefit claiming. The delay in benefit claiming appears to be driven by an interaction between minimum wages and the Social Security earnings test. These results suggest that retirement-age individuals are very responsive to changes in labor market opportunities and that minimum wages may complement Social Security incentives that encourage more work and delayed benefit claiming.

"The Impact of Educational Rewards on the Diagnosis of Autism Spectrum Disorder" (with Scott McNamara )

Economics and Human Biology, 2022, 47, 101188.

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that affects social interactions and communication. The prevalence of ASD has risen dramatically in recent years, but the underlying factors leading to this rise are not clear. In this paper, we test whether changes in state-level educational policy that impact school-level resources are associated with the rise in ASD diagnostic prevalence. Early identification of ASD can improve an array of outcomes for children, and school systems play an important role with identification of the condition. It is plausible that children attending schools with better resources from state governments are more likely to receive an ASD diagnosis and presumably appropriate services. We focus on one educational policy in particular, state-level rewards, which consist of a monetary transfer from state governments to school districts. To test the impact of educational rewards on ASD diagnosis, we rely on policy variation across states and time and estimate both two-way fixed effects (TWFE) models alongside recently advanced methods in the difference-in-differences (DiD) literature. Under a baseline TWFE specification we estimate that rewards policies are associated with a 18.46 percent increase in ASD diagnosis. Further, using DiD methods that account for bias in settings of differential policy timing, we find that the magnitude of the effect increases to 24.8 percent. We believe these findings to be suggestive evidence that educational rewards policies improved the likelihood of detection and diagnosis of ASD.

"Access to Health Care and Mental Health -- Evidence from the ACA Preexisting Conditions Provision" (with Otto Lenhart) Health Economics, 2022, 31(5), 760-783.

This study evaluates the impact of the Affordable Care Act preexisting conditions provision on mental health. The 2014 policy ensured individuals with preexisting health conditions the right to obtain insurance coverage. Using longitudinal data from the Panel Study of Income Dynamics between 2009 and 2017 and estimating difference-in-differences models, our study provides evidence that the policy reduced severe mental distress by 1.38 percentage points among individuals with preexisting physical health conditions. Exploiting pre-ACA, state-level variation in policies providing insurance coverage options to people with preexisting conditions, we find that this improvement in mental well-being is highly associated with the presence of high-risk pools before 2014, which provided individuals with prior health conditions access to coverage. Specifically, we show that our main results are driven by individuals with preexisting health conditions living in the 16 states that did not have high-risk pools. Furthermore, gender-specific analysis shows that the reduction in mental distress is primarily observable among women. When examining a potential mechanism, our analysis provides evidence that reductions in financial strain related to health expenditures can explain the positive effects of the provisions on mental well-being.

"The Effect of the Affordable Care Act Medicaid Expansion on Marriage" (with Otto Lenhart )

Economic Inquiry, 2022, 60(2), 568-591.

This paper investigates the impact of the Affordable Care Act Medicaid expansions on marital behavior. We use data from the American Community Survey from 2008 to 2019 and estimate difference-in-differences models to test for effects on marriage and divorce outcomes. We find that expansions led to a 0.95 percent reduction in marriage stock and a 2.22 percent increase in the stock of divorced individuals, with effects being larger among those with low education. We believe that two factors play a role as underlying mechanisms: 1) reduced reliance on spousal health insurance coverage, and 2) deciding to forego marriage or get divorced to meet post-policy eligibility restrictions.

"The Effect of the Affordable Care Act Preexisting Conditions Provision on Marriage" (with Otto Lenhart )

Health Economics, 2019, 28(11), 1345-1355.

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.

Working Papers

"School Accountability and Hyperactivity" (with Susan E. Chen)

Revise and Resubmit

Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly diagnosed mental health disorder among American children. In this paper, we examine whether continued school accountability policies in a post- No Child Left Behind period account for rises in ADHD prevalence. We estimate two-way fixed effects models that exploit variation across states and time in the introduction of school accountability laws to test for changes in mean ADHD diagnosis and prescription medication use. While we find no significant effects for consequential accountability laws, the results from our analysis suggest that the introduction of one specific policy instrument, state-level rewards given to high-performing schools, leads to a 1.9 percentage point increase in the probability of an ADHD diagnosis and a 1.0 percentage point increase in prescription medication use among children. We find that the effect is largest among children that are male, black, and covered by public insurance. Additionally, using a measure of state-level, per pupil spending on education, we find that the rewards policy is positive and significant for children in all quintiles of spending, except for those living in states among the bottom 20% of spenders. We believe that the rewards policy mechanism is a combination of both the presence of a financial incentive along with adequate resources devoted to schools by the state.

"Revisiting the Effect of the Affordable Care Act Medicaid Expansion on Migration" (with Laura Connolly and Otto Lenhart ) Under Review

We revisit the impact of the Affordable Care Act's Medicaid Expansion on interstate migration to determine the longer-run effects of the policy. Using American Community Survey data from 2010-2019 and a difference-in-differences (DiD) research design, we test for changes in migratory trends between expansion and non-expansion states. In contrast with prior findings examining short-run effects, we find evidence of increased post-policy migration from non-expansion-to-expansion states among those with Medicaid coverage. Staggered DiD methods indicate that increases in net migration to expansion states are driven by reduced out-migration from expansion states.

"Trends in Adolescent Suicide Behaviors in the State of Iowa" (with Lisa Hooper, Wei Schneider, and Sara Tomek) Under Review

Recent research has found that suicidality is increasing among Black American youths. In this paper, we test whether the reported increase in suicidality is evident in a sample of children living in the state of Iowa. Using data from the Youth Risk Behavior Surveillance System (YRBSS) over the period 1997-2019, we examine the trends in four measures of suicidal behavior among Iowa youth among sex and racial subsamples. We find that in general, suicidality among Iowa youth has been on the decline, except for one racial subcategory: Multiracial male adolescents. We find a concerning significant increase in suicidal ideation among this group, which suggests a new group of vulnerable youths. We conclude that some youth who identify as Multiracial males might suffer from feeling isolated due to sparse population and confusion in self-identification as adopting the dominant culture within society. Policymakers should take into consideration this particular subgroup within the state of Iowa when formulating strategies to combat mental illness and youth suicidality.

"Do Occupational Licensing Regulations Increase Earnings? Evidence from the U.S. Airline Industry" (with Michael Liby) Under Review

Congressional Bill H.R. 5900 increased training requirements to work for major airlines from 250 hours to 1,500 for civilian pilots, and to 750 for former military pilots. While the increase in training requirements may have improved flight safety, the policy potentially exacerbated pilot staffing issues for both airlines and the military. We test the impact of the change in policy on pilot earnings. Using American Community Survey data from 2005-2020, we identify over 24,000 pilots that we separate into three groups: Former Military Commercial, Civilian Commercial, and Active Duty Military. Utilizing a difference-in-differences research design we find that the policy led to increased relative earnings of commercial pilots, with Former Military Commercial pilots realizing the largest gains. We attribute earnings increases among Former Military Commercial pilots to their improved labor mobility following the policy implementation. Our study contributes to the occupational licensing literature by finding that increased regulatory requirements leads to higher wages. Additionally, we find empirical evidence that the change in policy worsened commercial and military pilot staffing issues.

"ACA Dependent Coverage and Reverse Crowd-Out" (with Chanita C. Holmes and Mohammad Movahed) Under Review

With one of the overarching goals of the Affordable Care Act being to decrease the proportion of uninsured individuals in the population, the Dependent Coverage Provision allows young adults to remain on parental health insurance plans until age 26. We test the impact of the policy on enrollment both in private and public health insurance and find evidence of a "reverse crowd-out" effect, a situation in which some young adults switched out of Medicaid and into private coverage following the policy. To estimate the extent of such reverse crowd-out, we analyze American Community Survey data from 2008-2022 and utilize difference-in-differences methods that compare insurance outcomes of young adults aged 23-25 to those of older young adults aged 27-30. We estimate a reverse crowd-out rate of 19.16 percent, which means that for every ten young adults who gained private coverage following the policy, there were two fewer covered by Medicaid. We explore policy heterogeneity using both triple differences and event study methods and find that reverse crowding-out was larger among non-working and self-employed individuals and smaller for males, Hispanic Americans, and married individuals.

Work in Progress

"The Impact of Caring for a Child with ADHD on Parental Outcomes"

"Childhood Disability and Parental Labor Outcomes"

"Understanding Trends in ADHD Prevalence: A Stochastic Dominance Approach" (with Susan E. Chen)

"Impacts of the Earned Income Tax Credit on Fertility" (with Otto Lenhart)

Teaching Experience

Assistant Professor, Austin Peay State University, 2021-present

ECON 2100 Principles of Macroeconomics (both in person and online)

ECON 2200 Principles of Microeconomics (both in person and online)

ECON 3010 Intermediate Microeconomics (both in person and online)

Assistant Professor, University of Northern Iowa, 2018-2021

ECON1031 Introduction to Economics (both Honors and Hybrid Format)

ECON 1021 Decision Analytics

ECON 2140 Health Economics

Instructor, University of Alabama, 2016-2018

EC 483/597 Health Care Economics

-Evaluations: 4.81/5 , 4.73/5

EC 308 Intermediate Microeconomics

-Evaluations: 4.67/5, 4.61/5

Instructor, Johns Hopkins Center for Talented Youth, Summer 2017

The Mathematics of Money

-Evaluations: 4.53/5

Teaching Assistant, University of Alabama, 2013-2018

EC 308 Intermediate Microeconomics

LGS 200 Legal Environment of Business

EC 110 Principles of Microeconomics

Honors and Awards

Best Student Paper Award, "Do Occupational Licensing Regulations Increase Earnings? Evidence from the U.S. Airline Industry" (coauthored with Michael Liby, Society of Business, Industry, and Economics Annual Meetings, Spring 2023

AJ Taylor Distinguished Professorship Award, APSU College of Business

Fall 2022 (link)

CORE-Teagle Fellow, The CORE-Project,

Fall 2017

Economics, Finance, and Legal Studies Summer Research Grant, University of Alabama

Summer 2017

Nominated for Student Employee of the Year, University of Alabama

Spring 2017

Dean Recognition for Teaching Excellence, University of Alabama

Spring 2017

Summer Excellence in Research (SEiR) Grant, University of Alabama

Summer 2016