Are Public Housing Projects Good For Kids?

One goal of federal housing policy is to improve the prospects of children in poor families. But little research has been conducted into the effects on children of participation in housing programs, perhaps because it is difficult to find data sets with information about both participation and interesting outcome measures. This paper combines data from several sources to provide a first look at the effects of participation in public housing projects on housing quality and on the educational attainment of children. We first use administrative data from the Department of Housing and Urban Development to impute the probability that a Census household lives in a public housing project. We find that a higher probability of living in a project is associated with poorer outcomes. We then use a two-sample instrumental variables (TSIV) technique to combine information on the probability of living in a project, obtained from the 1990 to 1995 Current Population Surveys, with information on outcomes obtained from the 1990 Census. The instrument common to both samples is an indicator equal to one if the household is entitled to a larger housing project unit because of the sex composition of the children in the household. Families entitled to a larger unit because of sex composition are 24 percent more likely to live in projects. When we control for omitted variables bias using TSIV, we find that project households are less likely to suffer from overcrowding and less likely to live in high-density complexes. Project children are also 12 to 17 percentage points less likely to have been held back in school one or more grades, although this effect is confined to boys. Thus, most families do not face a tradeoff between housing quality and child outcomes—the average project improves both.

Did recent medicaid reforms cause the caseload explosion in the food stamp program?

I examine whether changes in Medicaid eligibility for young children can help explain the caseload growth in the Food Stamp program between 1987 and 1995. Medicaid may increase food stamp participation through increased awareness about other welfare benefits. It could also reduce earnings through perverse labor supply incentives, thereby increasing food stamp participation. The Medicaid expansions enacted during the 1980s offer a unique opportunity to examine empirically Medicaid's interaction with the Food Stamp program because they conditioned eligibility on the age of the child. Households with ineligible children (based on the child's age) serve as a control group to isolate Medicaid's effect. They help to eliminate many other plausible explanations for the rise in food stamp participation, including economic fluctuations at the state and national levels. I use the Survey of Income and Program Participation (SIPP) to tackle this question. It shows evidence that expanding Medicaid eligibility increased food stamp participation. The effect is quite modest, however. The expansions explain less than 10 percent of the growth in food stamps, substantially smaller than previous estimates. Moreover, its effect on food stamp participation comes entirely through increased program awareness, rather than from any change in labor supply.

Public Health Insurance and Private Savings

Recent theoretical work suggests that means and asset-tested social insurance programs can explain the low savings of lower income households in the United States. We assess the validity of this hypothesis by investigating the effect of Medicaid, the health insurance program for low-income women and children, on savings behavior. We do so using data on asset holdings from the Survey of Income and Program Participation, and on consumption from the Consumer Expenditure Survey, matched to information on the eligibility of each household for Medicaid. Exogenous variation in Medicaid eligibility is provided by the dramatic expansion of this program over the 1984–1993 period. We document that Medicaid eligibility has a sizeable and significant negative effect on wealth holdings; we estimate that in 1993 the Medicaid program lowered wealth holdings by 17.7 percent among the eligible population. We confirm this finding by showing a strong positive association between Medicaid eligibility and consumption expenditures; in 1993, the program raised consumption expenditures among eligibles by 5.2 percent. We also exploit the fact that asset testing was phased out by the Medicaid program over this period to document that these Medicaid effects are stronger in the presence of an asset test, confirming the importance of asset testing for household savings decisions.

Public Policy and Health Care Choices of the Elderly: Evidence from the Medicare Buy-In Program

This study provides evidence on the economic decisions of senior citizens with respect to the largest means-tested program in the United States: the Medicaid program. Virtually all senior citizens have health insurance coverage through Medicare, but poor seniors may also be eligible for Medicaid, which fills in many of the gaps in Medicare coverage. Since 1987, the Medicaid program has undergone a series of changes relating to eligibility. In particular, two new categories of elderly Medicaid recipients, known as Qualified Medicare Beneficiaries (QMBs) and Specified Low-Income Medicare Beneficiaries (SLMBs), were created. This study uses the Survey of Income and Program Participation to explore three issues relating to the expansions. First, how much did the QMB expansions increase Medicaid eligibility? Second, how did increases in Medicaid eligibility affect supplemental insurance coverage? Finally, does increased Medicaid coverage translate into increased health care utilization? There are five principal findings. First, actual Medicaid eligibility increased dramatically, from 8 percent in 1987 to 12.5 percent in 1995. Second, the expansions for the elderly resulted in dramatically higher Medicaid take-up rates than similar expansions for children. For every 100 elderly who became eligible, 49 took it up. Nearly 30 out of 100 elderly dropped private coverage, however, resulting in crowd out of 60 percent. Third, crowd out was concentrated among the youngest of senior citizens. Fourth, crowd out came from individuals dropping privately purchased health insurance rather than dropping employer-provided retiree health insurance. Finally, Medicaid coverage increased the number of hospitalizations, though the findings on health care utilization are generally inconclusive.

Will Extending Medicaid to Two-Parent Families Encourage Marriage?

Several welfare programs in the United States restrict eligibility to single-parent families. This paper asks whether eliminating this restriction for Medicaid encourages marriage. I identify Medicaid's effect through a series of health insurance reforms that were passed in the 1980s and 1990s targeting young children. These reforms were associated with an increase in the probability of marriage of 1.7 percentage points. While the expansions offered some incentives to become married, they also created other incentives to become divorced (known as the "independence effect"). After controlling for the outflows from marriage due to the independence effect, the estimated effect increases by 10 percent.

Why did the SSI-disabled program grow so much? Disentangling the effect of Medicaid

The participation rate for working-age adults in the Supplemental Security Income (SSI) program increased by 37 percent from 1987 to 1993. This paper examines the role of public health insurance provided through Medicaid on the SSI participation decision. I use the rapid growth in Medicaid expenditure across states and over time as a proxy for its value. The estimation is complicated by the easing of standards for determining disability. If the marginal individual who entered SSI under these easier standards was healthier than the average participant, then average Medicaid expenditure would fall. Thus, conventional OLS estimates could lead to a spurious negative correlation between average Medicaid expenditure and SSI participation. I therefore apply two-stage least squares (TSLS) to estimate Medicaid's effect, using Medicaid expenditure for blind and elderly SSI recipients, and adult and child AFDC recipients as instruments for disabled Medicaid expenditure. The TSLS estimates indicate that rising Medicaid expenditure significantly increased the SSI participation for whites, but had little effect on African Americans. Among whites, the rising value of Medicaid explains one-third of the growth in SSI participation.

The Medicaid notch, labor supply, and welfare participation: Evidence from eligibility expansions

I assess the impact of losing public health insurance on the labor market decisions of women by examining a series of Medicaid eligibility expansions targeted toward young children. These targeted expansions severed the historical tie between AFDC and Medicaid eligibility. The reforms allowed a mother's earnings to increase without affecting her young children's public health insurance. Increasing the income limit for Medicaid resulted in a decrease in AFDC participation and an increase in labor force participation among these women. The effects were large for ever-married women, but were negligible for never-married women.

Employer Health Insurance Mandates and the Risk of Unemployment

Employer health insurance mandates form the basis of many health care reform proposals. Proponents make the case that they will increase insurance, while opponents raise the concern that low-wage workers will see offsetting reductions in their wages and that in the presence of minimum wage laws some of the lowest wage workers will become unemployed. We construct an estimate of the number of workers whose wages are so close to the minimum wage that they cannot be lowered to absorb the cost of health insurance, using detailed data on wages, health insurance, and demographics from the Current Population Survey (CPS). We find that 33 percent of uninsured workers earn within $3 of the minimum wage, putting them at risk of unemployment if their employers were required to offer insurance. Assuming an elasticity of employment with respect to minimum wage increase of -0.10, we estimate that 0.2 percent of all full-time workers and 1.4 percent of uninsured full-time workers would lose their jobs because of a health insurance mandate. Workers who would lose their jobs are disproportionately likely to be high school dropouts, minority, and female. This risk of unemployment should be a crucial component in the evaluation of both the effectiveness and distributional implications of these policies relative to alternatives such as tax credits, Medicaid expansions, and individual mandates, and their broader effects on the well-being of low-wage workers.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73099/1/j.1540-6296.2008.00133.x.pd