Dissertations, Theses, and Capstone Projects

Date of Degree

6-2016

Document Type

Dissertation

Degree Name

Ph.D.

Program

Economics

Advisor

Michael Grossman

Committee Members

Wim Vijverberg

David Jaeger

Subject Categories

Economics | Health Economics | Labor Economics

Keywords

Health Economics, Health Policy, Labor Economics

Abstract

This dissertation is motivated by changes in health and labor policies of the United States that have occurred over the last two decades. It examines how these policies as well as public programs affect behavior and outcomes. These programs and policies have the potential to impact behavior directly at the individual level and could also have indirect effects at the household level. In addition, the effects on healthcare use and health status are also examined. This dissertation consists of three chapters.

The first chapter looks at the effect of changes in Medicaid policy on legal immigrant parents in the United States. During the 1990s and early 2000s many states expanded Medicaid eligibility for parents particularly after the 1996 welfare reform. At the same time, welfare reform also put in place policies that limited the eligibility of recent legal immigrants for public programs including Medicaid. In this chapter the effects of these changes in Medicaid eligibility policy on the private and public health insurance coverage of immigrants as well as the overall insurance rate. It also looks at the effect on health care use and measures of health status. The findings indicate a significant increase in Medicaid coverage and an increase in the proportion insured overall with negligible crowd-out of private insurance. There is also an increase in the use of health care services and improved health status particularly for foreign born citizens. In the case of longer tenure permanent residents, there is a diminished response to Medicaid eligibility changes possibly due to a ''chilling" effect.

The second chapter evaluates the impact of the Healthy Start program on infant mortality outcomes at the county level. Prior studies have found that various policy changes and programs affected the US infant mortality rate over time. This chapter examines the effect of the Healthy Start program in parts of the United States on infant mortality rates. Using data from the CDC WONDER database as well as other sources the program is evaluated using synthetic control methods. The findings show that Healthy Start has been able to reduce infant mortality rate in certain areas, while it has been less effective in other sites. This could be due to each program site being separately run, although all programs have the same funding source.

The third chapter examines the effect of changes in the minimum wage on adults and households with education levels. It exploits variation in the minimum wage to examine its impact on health and health care use. A large proportion of previous research on the minimum wage examines its employment effects. This chapter looks at a different dimension. Using data from the Survey for Income and Program Participation (SIPP) from 1996-2005 and 2010-2011, it estimates the effect of minimum wage variation on general health and health care use for adults with less than a high school education and also those of college educated adults, as well as their dependents. The results show an increase in the use of healthcare services for adults with less than a high school education as well as their dependents. There is no significant effect on those in the higher education group.

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