My research interests include health economics, labor economics, and applied microeconomics.
(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.
"The Effect of the ACA Medicaid Expansion on Marriage Behavior" (with Otto Lenhart ) Under Review
This paper investigates the impact of the 2014 Medicaid expansions on marital behavior. The Patient Protection and Affordable Care Act (ACA) encouraged states to expand Medicaid and thereby reduce the number of uninsured individuals. We test whether the Medicaid expansions led to a decrease in marriage and an increase in divorce. We add to earlier work on how marital behavior is influenced by the availability of insurance options. Using data from the Current Population Survey from 2010 to 2018 and estimating difference-in-differences models, we show that the expansions increased Medicaid coverage by 54.92 percent. When evaluating the effects of the policy change on marriage behavior, we find that individuals living in states that expanded their Medicaid programs in 2014 were 2.13 percent less likely to be married and 3.82 percent more likely to be divorced, with the effects being larger for low-educated people. We believe the effect to be a combination of a decrease in reliance on spousal health insurance coverage and a response to incentives to meet eligibility restrictions for Medicaid.
"School Accountability and Hyperactivity" (with Susan E. Chen) Under Review
Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly diagnosed mental health disorder among American children. In this paper, we examine whether incentives built into school policy can affect the reporting of ADHD symptoms by parents and subsequent ADHD diagnosis. Specifically, we explore whether the introduction of school accountability policies can account for changes in ADHD prevalence. To do so, we exploit differences across states and across time in the introduction of school accountability laws to estimate differences in mean ADHD prevalence. The results from our analysis suggest that the introduction of one specific policy instrument, state-level rewards given to high-performing schools, leads to approximately a 3 percentage point increase in the probability of an ADHD diagnosis among children. To better understand who these newly diagnosed children are, we construct distributions of mother-reported behavioral problems. We find that the children most impacted by the policy are those whose mothers' reported zero behavioral problems in the pre-policy period, perhaps indicating that prior to the policy these mothers were unaware of their child's behavioral problems.
"Minimum Wages and Retirement Decisions" (with Evan Totty)
This study uses linked survey-administrative data to assess the relationship between minimum wages and claiming of social security retirement insurance. We analyze the relationship between minimum wages and retirement by focusing on near- or at-retirement aged workers. These results have important implications for understanding the comprehensive effect of minimum wages for both workers and the government by providing new evidence on minimum wages and receipt of public assistance. First, we show that minimum wage increases are associated with greater earnings and probability of being employed for individuals ages 55-70, although this is mostly for the relatively younger individuals. Next, we show that minimum wage increases that occur when an individual is 65 are associated with a decrease in the probability of claiming retirement benefits at that age. Age 65 is the first age at which most of our sample is eligible for full retirement benefits.
"The Impact of Caring for a Child with ADHD on Parental Outcomes"
Caring for a child with a learning disorder can negatively impact both parental relationships and labor market activity. For instance, as children with attention deficit hyperactivity disorder (ADHD) often display impulsive behaviors, caring for the child may lead to added strain on a marriage. Additionally, to better facilitate child learning and development, parents may devote less time to the labor market and more time at home. In this paper, we study the impact of caring for a child with ADHD on parental labor market and relationship dissolution outcomes. As outcomes and ADHD status may be simultaneously influenced by unobservable characterstics of parents, we use an instrumental variables approach to address the endogeneity issue inherent within the topic. We find that parents of ADHD children work less hours per week, less weeks per year, and are significantly more likely to be out of the labor force than those of healthy children. Additionally, we find that parents of children with ADHD are more likely to be divorced within the ten years following the birth of the child.
"Access to Health Care and Mental Health -- Evidence from the Affordable Care Act" (with Otto Lenhart)
This study evaluates whether the implementation of the Affordable Care Acts preexisting conditions provision in 2014 affected mental health outcomes of individuals benefiting from the policy. The reform ensured individuals with preexisting health conditions the right to obtain insurance coverage by preventing insurers from denying 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 mental distress of individuals with preexisting physical health conditions. We find that the provision reduced the likelihood of affected individuals being in severe mental distress by 17.7 percent, with heterogeneity analysis revealing the improvement to be primarily within women. When examining potential mechanisms underlying the link between the reform and mental health, we show that the policy significantly reduced financial strain related to health care and insurance expenditures. We also find evidence of reductions in the likelihood of being married among people with preexisting conditions, which suggests that reduced reliance on spousal insurance coverage may have also played a role.
"Understanding Trends in ADHD Prevalence: A Stochastic Dominance Approach" (with Susan E. Chen)
The Behavioral Problems Index (BPI) was created to measure the severity of childhood behavioral problems and as a metric for diagnosing conditions such as Attention Deficit Hyperactivity Disorder (ADHD). In this case, an ADHD diagnosis is correlated with a child surpassing a certain BPI threshold. In this paper, we use stochastic dominance techniques to understand how the reporting of behavioral problems as well as ADHD prevalence has changed across time. Studying a sample of U.S. children, we focus on two time periods: the early 1990s and the early 2000s. These two time periods coincide with changes in the Supplemental Security Income (SSI) program and national educational policy, respectively. We hypothesize that these policies may have influenced the reporting of behavioral problems in children and a change in ADHD prevalence. We construct a reduced form model of hyperactivity and use decomposition techniques to provide further evidence that both SSI and educational policy had an impact on ADHD prevalence.
Work in Progress
"Understanding the Recent Rise in Autism Spectrum Disorder" (with Scott McNamara)
"Childhood Disability and Parental Labor Outcomes" (with Susan E. Chen)