Impacts of shifting responsibility for high-cost individuals on Health Insurance Exchange plan premiums and cost-sharing provisions
Publication date: Available online 23 May 2019Source: Journal of Health EconomicsAuthor(s): Miaomiao ZouAbstractInsurance companies can respond to increases in expected per-capita healthcare expenditures by adjusting premiums, cost-sharing requirements, and/or plan generosity. We use a Difference-in-Difference model with Plan-level Fixed Effects to estimate the impacts of increases in expected expenditures generated by closure of state-operated High Risk Pools (HRPs). For Silver plans, we find that issuers responded to HRP closures by increasing both premiums and deductibles, and by increasing the ratios of premiums to ded...
Source: Journal of Health Economics - May 24, 2019 Category: Health Management Source Type: research
Birth Weight and Vulnerability to a Macroeconomic Crisis
Publication date: Available online 23 May 2019Source: Journal of Health EconomicsAuthor(s): Prashant Bharadwaj, Jan Bietenbeck, Petter Lundborg, Dan-Olof RoothAbstractThis paper shows that early-life health is an important determinant of labor market vulnerability during macroeconomic downturns. Using data on twins during Sweden's crisis of the early 1990s, we show that individuals with higher birth weight are differentially less likely to receive unemployment insurance benefits after the crisis as compared to before it, and that this effect is concentrated among workers in the private sector. While differences in early-li...
Source: Journal of Health Economics - May 24, 2019 Category: Health Management Source Type: research
Competition and physician behaviour: Does the competitive environment affect the propensity to issue sickness certificates?
Publication date: Available online 21 May 2019Source: Journal of Health EconomicsAuthor(s): Kurt R. Brekke, Tor Helge Holmås, Karin Monstad, Odd Rune StraumeAbstractCompetition among physicians is widespread, but compelling empirical evidence on its impact on service provision is limited, mainly due to endogeneity issues. In this paper we exploit that many GPs, in addition to own practice, work in local emergency centres, where the matching of patients to GPs is random. The same GP is observed both with competition (own practice) and without (emergency centre). Using high-dimensional fixed-effect models, we find that GPs ...
Source: Journal of Health Economics - May 22, 2019 Category: Health Management Source Type: research
The Effect of Paid Family Leave on Infant and Parental Health in the United States
Publication date: Available online 16 May 2019Source: Journal of Health EconomicsAuthor(s): Lindsey Rose BullingerAbstractCalifornia’s paid family leave (PFL) policy improved mothers’ labor market outcomes, however, the health impacts of this program are less studied. I compare child and parental health of likely eligible households to a series of control groups before and after California’s PFL program was implemented. I find improvements in parent-reported overall child health and suggestive improvements in maternal mental health status. Findings also suggest a reduction in asthma and a greater likelihood that pare...
Source: Journal of Health Economics - May 16, 2019 Category: Health Management Source Type: research
E-Cigarette Minimum Legal Sale Age Laws and Traditional Cigarette Use among Rural Pregnant Teenagers
Publication date: Available online 13 May 2019Source: Journal of Health EconomicsAuthor(s): Michael F. Pesko, Janet M. CurrieAbstractTeenagers under 18 could legally purchase e-cigarettes until states passed minimum legal sale age laws. These laws may have curtailed teenagers' use of e-cigarettes for smoking cessation. We investigate the effect of e-cigarette minimum legal sale age laws on prenatal cigarette smoking and birth outcomes for underage rural teenagers using data on all births from 2010 to 2016 from 32 states. We find that the laws increased prenatal smoking in by 0.6 percentage points (pp) overall. These effect...
Source: Journal of Health Economics - May 14, 2019 Category: Health Management Source Type: research
Teen driver licensure provisions, licensing, and vehicular fatalities
In this study, separate GDL provisions and no pass, no drive laws are studied to understand reduction mechanisms. The evaluation is based on a state-by-year panel and uses difference-in-difference and triple-difference specifications to identify causal impacts on rates of licensing, vehicular fatalities, and fatalities per licensee.The empirical results find that the minimum intermediate licensing age of 16.5 or older provision reduces licensing of 16- to 17-year-old teens by 20.1%, and no other licensure provision consistently impacts licensing. In addition, vehicular fatalities decrease from the minimum intermediate lice...
Source: Journal of Health Economics - May 12, 2019 Category: Health Management Source Type: research
The willingness to pay for health improvement under comorbidity ambiguity
This study examines the conditions under which the willingness to pay for health improvement is larger with comorbidity ambiguity than without it. This study also examines the effect of changes in ambiguity and ambiguity aversion on the willingness to pay. (Source: Journal of Health Economics)
Source: Journal of Health Economics - May 10, 2019 Category: Health Management Source Type: research
The effect of retirement on elderly cognitive functioning
This article estimates the short-term effect of retirement on cognitive performance of elderly Australians by exploiting the exogenous variation in retirement decisions induced by changes in social security eligibility rules. The empirical results show that on average retirement has a negative but modest effect on cognition, and the rate of cognitive decline with age is greater for men than women. The results for women display no significant effects on working memory and speed of information processing. The article further adds to the literature by providing evidence on the possible mechanisms through which retirement coul...
Source: Journal of Health Economics - May 10, 2019 Category: Health Management Source Type: research
Minimum unit prices for alcohol
Publication date: July 2019Source: Journal of Health Economics, Volume 66Author(s): Paul CalcottAbstractMinimum unit prices (MUPs) have been proposed on the grounds that they can reduce alcohol consumption of the heaviest drinkers, without significantly burdening moderate drinkers. This paper examines the case for MUPs in an optimal tax framework. Such a policy can improve welfare when two conditions are both satisfied. First, beverage quality and quantity should be substitutes. Second, there should be more distortion to consumption of cheaper alcohol than to more expensive varieties. The consequences of a MUP for the opti...
Source: Journal of Health Economics - May 10, 2019 Category: Health Management Source Type: research
Sunset time and the economic effects of social jetlag: evidence from US time zone borders
This study uses a spatial regression discontinuity design to estimate the economic cost of the misalignment between social and biological rhythms arising at the border of a time-zone in the presence of relatively rigid social schedules (e.g., work and school schedules). Exploiting the discontinuity in the timing of natural light at a time-zone boundary, we find that an extra hour of natural light in the evening reduces sleep duration by an average of 19 minutes and increases the likelihood of reporting insufficient sleep. Using data drawn from the Centers for Disease Control and Prevention and the US Census, we find that t...
Source: Journal of Health Economics - April 28, 2019 Category: Health Management Source Type: research
Health-Related Life Cycle Risks and Public Insurance
Publication date: Available online 25 April 2019Source: Journal of Health EconomicsAuthor(s): Daniel KemptnerAbstractBased on a dynamic life cycle model, this study analyzes health-related risks of consumption and old-age poverty. The model allows for health effects on employment risks, on productivity, on longevity, the correlation between health risks, productivity and preferences, and the financial incentives of the German public insurance schemes. The estimation uses data on male employees and an extended Expectation-Maximization algorithm. Simulations suggest that health shocks induce average losses in annual consumpt...
Source: Journal of Health Economics - April 25, 2019 Category: Health Management Source Type: research
Childhood Health Shocks, Comparative Advantage, and Long-Term Outcomes: Evidence from the Last Danish Polio Epidemic
Publication date: Available online 23 April 2019Source: Journal of Health EconomicsAuthor(s): Miriam Gensowski, Torben Heien Nielsen, Nete Munk Nielsen, Maya Rossin-Slater, Miriam WüstAbstractThis paper examines the long-term effects of childhood disability on individuals’ educational and occupational choices, late-career labor market participation, and mortality. We merge medical records on children hospitalized with poliomyelitis during the 1952 Danish epidemic to census and administrative data, and exploit quasi-random variation in paralysis incidence in this population. While childhood disability increases the likel...
Source: Journal of Health Economics - April 25, 2019 Category: Health Management Source Type: research
Uterus at a Price: Disability Insurance and Hysterectomy
Publication date: Available online 23 April 2019Source: Journal of Health EconomicsAuthor(s): Elliott Fan, Hsienming Lien, Ching-to Albert MaAbstractTaiwanese Labor, Government Employee, and Farmer Insurance programs provide 5 to 6 months of salary to enrollees who undergo hysterectomies or oophorectomies before their 45th birthday. These programs create incentives for more and earlier treatments, referred to as inducement and timing effects. Using National Health Insurance data between 1997 and 2011, we estimate these effects on surgery hazards by difference-in-difference and bunching-smoothing polynomial methods. For Gov...
Source: Journal of Health Economics - April 23, 2019 Category: Health Management Source Type: research
Sunset Time and the Economic Effects of Social Jetlag Evidence from US Time Zone Borders
This study uses a spatial regression discontinuity design to estimate the economic cost of the misalignment between social and biological rhythms arising at the border of a time-zone in the presence of relatively rigid social schedules (e.g., work and school schedules). Exploiting the discontinuity in the timing of natural light at a time-zone boundary, we find that an extra hour of natural light in the evening reduces sleep duration by an average of 19 minutes and increases the likelihood of reporting insufficient sleep. Using data drawn from the Centers for Disease Control and Prevention and the US Census, we find that t...
Source: Journal of Health Economics - April 14, 2019 Category: Health Management Source Type: research
[Job] Locked and [Un]loaded: The effect of the Affordable Care Act dependency mandate on reenlistment in the U.S. Army
Publication date: May 2019Source: Journal of Health Economics, Volume 65Author(s): Michael S. Kofoed, Wyatt J. FrasierAbstractOne concern with employer-based health insurance is job lock or the inability for employees to leave their current employment for better opportunities for fear of losing benefits. We use the implementation of the Affordable Care Act's dependency mandate as a natural experiment. Data from the United States Army overcome some limitations in previous studies including the ability to examine workers with fixed contract expiration dates, uniform pay, and health coverage. We find that the ACA decreased re...
Source: Journal of Health Economics - April 13, 2019 Category: Health Management Source Type: research
