Trends in Intergenerational Earnings Mobility

This paper examines trends in intergenerational earnings mobility by estimating ordinary least squares, quantile regression, and transition matrix coefficients using five cohorts from the Panel Study of Income Dynamics, observed between 1968 and 1993. The results indicate that mobility increased for sons with respect to fathers and remained constant for sons and daughters with respect to mothers. Moreover, the findings from the father-son sample suggest that the difference between the mobility levels of the rich and the poor narrowed over this period. The estimated pattern of changing mobility is consistent with an increasing rate of regression to the mean.

Is Intergenerational Earnings Mobility Affected by Divorce?

This study examines whether the intergenerational transmission of human capital, measured by intergenerational earnings mobility, is affected by divorce. Using the Panel Study of Income Dynamics, I find that, with each additional year in a family involving a single or a step parent, the earnings mobility between biological fathers and children rises and the mobility between mothers and daughters falls. However, using either sibling fixed effects or instrumental variable estimation, I find that the association between family structure and father-child mobility is explained by selection. These findings have two important implications. First, they imply that the increase in father-son mobility observed in other studies can be explained by the rise in single and step parent families over the same period. Second, these findings imply that the connection between fathers and children would have been weak whether or not a divorce occurred, which does not support the hypothesis that father absence is an important factor contributing to differences in child outcomes across family structures.intergenerational earnings mobility, family structure

Portfolio choice and mental health

Abstract. Close to 30% of the US population experiences at least one mental or substance abuse disorder each year. Given the prevalence of mental health issues, this paper analyzes the role of mental health and cognitive functioning in household portfolio choice decisions. Generally, we find that households affected by mental health issues decrease investments in risky instruments. Various mental health issues can reduce the probability of holding risky assets by up to 19%. Moreover, single women diagnosed with psychological disorders increase investments in safe assets. We also find that cognitive functioning issues are associated with an increase in financial assets devoted to retirement accounts

Portfolio choice and mental health

Abstract. Close to 30% of the US population experiences at least one mental or substance abuse disorder each year. Given the prevalence of mental health issues, this paper analyzes the role of mental health and cognitive functioning in household portfolio choice decisions. Generally, we find that households affected by mental health issues decrease investments in risky instruments. Various mental health issues can reduce the probability of holding risky assets by up to 19%. Moreover, single women diagnosed with psychological disorders increase investments in safe assets. We also find that cognitive functioning issues are associated with an increase in financial assets devoted to retirement accounts

Minimum drinking age laws and infant health outcomes

Alcohol policies have potentially far-reaching impacts on risky sexual behavior, prenatal health behaviors, and subsequent outcomes for infants. After finding initial evidence in the National Longitudinal Survey of Youth (NLSY) that changes in the minimum legal drinking age (MLDA) are related to prenatal drinking, we examine whether the drinking age influences birth outcomes. Using data from the National Vital Statistics (NVS) for the years 1978-1988, we find that a drinking age of 18 is associated with adverse outcomes among births to young mothers--including higher incidences of low birth weight and premature birth, but not congenital anomalies. The effects are largest among black women. We also report evidence that the MLDA laws alter the composition of births that occur. In states with lenient drinking laws, young black mothers are less likely to report paternal information on the birth certificate, particularly in states with restrictive abortion policies. The evidence suggests that lenient drinking laws generate poor birth outcomes in part because they increase the number of unplanned pregnancies.Alcohol Minimum drinking age Infant health Birth weight Prematurity

Contraceptive Choice After the Affordable Care Act

Background/Aims: The Affordable Care Act (ACA) mandated that, starting in late 2012, private health insurance plans that are not exempt or grandfathered were required to cover all contraceptive methods approved by the U.S. Food and Drug Administration as prescribed for women without a patient copayment. This policy has the potential to save billions in health care expenditures by reducing the number of unintended pregnancies, thereby reducing the number of deliveries and elective abortions. This study investigated the effect of the ACA-induced change in cost-sharing for contraceptive care on the rate of contraceptive use, the choice between long- and short-term contraceptive methods and the probability of elective abortion. Methods: We used longitudinal health insurance claims data on female enrollees 18–45 years old (N = 29,990) in insurance plans obtained through 499 employer groups with at least 50 enrollees. Medical and pharmacy claims from 2008 through 2014 were extracted for the sample. Our control group was women covered by the employers who had not yet complied with the ACA-mandated cost sharing as of the end of 2014. We modeled their contraceptive choice using a multinomial probit regression with individual random effects to control for the woman’s time-invariant unobserved characteristics. In a second regression, we modeled elective abortion using a binary probit regression with random effects. Results: We found that when the copay for contraceptives fell to $0 for those in compliant plans, contraceptive use rose substantially more than for those in noncompliant plans. Moreover, the mandate has increased the probability that a woman chose a long-term contraceptive method above and beyond the general increasing trend for these methods. We also observed a marginally significant decline in elective abortions. Conclusion: These findings suggest that women are price-sensitive with regard to contraception choice, and thus the ACA mandate will likely significantly reduce the rate of unintended pregnancy. Because unwanted pregnancy is associated with poor birth outcomes, this policy also has the potential to reduce the fraction of high-cost births and children in poor health

Pent-Up Demand After the Affordable Care Act

Background/Aims: Many state agencies, insurers and providers expected newly insured individuals under the Affordable Care Act (ACA) to inundate the health care market with high demand for health care. High health care utilization among newly insured individuals could indicate higher health risk and/or pent-up demand, defined as initial utilization caused by foregoing or delaying care while uninsured or underinsured. This study provides evidence regarding the relative health risk and pent-up demand for health care among newly insured adults in Medicaid as health reform rolls out. Methods: We used claims data from a large health insurer to examine the first six months of Medicaid coverage for Minnesota adults 18–64 years old who were newly enrolled between January and March 2014 (n = 4,252). The comparison group was nonelderly Minnesota adults with Medicaid coverage with this insurer in 2013 (n = 21,556). We compared seven types of health care utilization over six months for new and ongoing enrollees: all office visits, new patient office visits, emergency department visits, inpatient stays, diagnostic procedures, all prescriptions filled, and new prescriptions filled. We estimated logit models of the probability of having each type of health care utilization adjusting for age, gender, race/ethnicity and enrollee neighborhood characteristics. We used the coefficient estimates from these models to predict the likelihood of utilizing services as new enrollees compared to ongoing enrollees. Results: We found lower average predicted rates of health care utilization among new Medicaid enrollees compared to similar ongoing enrollees, with one exception –– new enrollees were more likely to have a new patient visit. In addition, we found that utilization among new enrollees declined during the first six months of coverage in every category except prescriptions filled. Conclusion: Our analysis of the first six months of Minnesota’s 2014 Medicaid expansion suggests both lower health care needs relative to similar ongoing enrollees and the presence of pent-up demand. This preliminary evidence suggests that both the long-term costs of covering the newly insured and the ongoing pressure on provider supply under the ACA may be lower than expected

The Effect of Hard-Stop Medicaid Payment Reform on Early Elective Deliveries

Background/Aims: We assessed the impact of Texas’s Medicaid payment reform for early elective delivery on clinical care practices and perinatal outcomes. Methods: We used National Vital Statistics System data for the years 2009–2013, which contained birth certificate records from all U.S. states and the District of Columbia. Data were merged to the 2014-2015 Area Health Resource File, which provided information on county-level economic and primary care provider characteristics for the five years in our study. Our key outcomes included early elective deliveries (induced and cesarean sections combined as well as cesarean section only), gestational age, birth weight (total, low birth weight, very low birth weight, large for gestational age) and early nonelective deliveries. We employed a difference-in-differences strategy to isolate the effect of the hard-stop policy in Texas from unrelated underlying trends present in control states. Models were adjusted for characteristics of the delivery and mother, if a father was not present on the birth certificate, county-level economic and provider trends, state-specific time trends, state fixed effects and linear time trends. Results: Relative to the control states, there were significant reductions in early elective inductions of labor among Medicaid deliveries in Texas, including reduced rates of cesarean births. Of Texas births paid by Medicaid, 11.2% were the result of early elective induction of labor prior to hard-stop legislation; after adjusting for changes in early inductions in comparison states, this share dropped by 1.1 percentage points (P \u3c 0.001). Birth outcomes also improved for babies covered by Medicaid in Texas, with relative increases in average gestational age and average birth weight. Conclusion: Findings from this study suggest that the Medicaid hard-stop policy in Texas was effective in reducing the rate of early elective deliveries among the Medicaid population. As a result, babies covered by this policy reached an older gestational age and greater gestational weight. Since Texas had one of the highest rates of early elective delivery prior to enacting hard-stop, we would expect that states with similar baseline rates also would have relatively large reductions in early elective delivery rates should they pass hard-stop legislation