Three Essays on Health Insurance

Hulbert, Jeffrey Michael, Department of Economics, University of Virginia
Friedberg, Leora, Department of Economics, University of Virginia
Pepper, John, Department of Economics, University of Virginia
Miller, Amalia, Department of Economics, University of Virginia
Turner, Sarah, Curry School of Education, University of Virginia

This dissertation investigates how recent changes in government health insurance policy affect child health and young adult labor market outcomes. In my first chapter I investigate how changes to Medicaid primary care physician payments impact the underlying health of Medicaid beneficiaries. I use the rate of ambulatory care sensitive discharges to Medicaid payers to measure child health. These are hospitalizations that are responsive to access and quality of primary care like diabetes, malnutrition, and immunizable diseases. I find that reductions to Medicaid payments for sick visits leads to an increase in ambulatory care sensitive discharges. In my second chapter I examine how state extended dependent coverage laws change the job choices of young adults. These laws allow young adults to remain on their parents' health insurance plans up to maximum ages between 24 and 30. I focus on three dimensions of labor market outcomes: hours worked, employer firm-size, and industry choice. I find that this outside source of health insurance reduces hours worked, reduces the firm-size of chosen employers, and leads young adults to work more in industries that do not typically offer health insurance plans. In my third chapter I study the impact of the Patient Protection and Affordable Care Act extended dependent coverage provision on young adult's labor market outcomes. I find that the impact of the federal expansion of extended dependent coverage mimicked the impact of state laws. The ACA also reduced hours worked, reduced firmii size of employers, and led young adults to work in industries less likely to offer health insurance. The impact of the ACA was lower in magnitude than state laws and concentrated in states without previous extended coverage laws.

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PHD (Doctor of Philosophy)
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