Labor Market and Outreach Effects of Medicaid Expansion Under the Affordable Care Act

The Affordable Care Act\u27s (ACA) Medicaid expansion is unique in terms of expanding coverage to adults without dependent children ( childless adults ) and increasing community-based outreach to raise awareness about coverage options. This dissertation explores the labor market and outreach effects of the ACA\u27s Medicaid expansion on childless adults and parents, respectively.First chapter of the dissertation investigates the pre/post labor market implications of the ACA\u27s Medicaid expansion for a population near the income eligibility cutoff. Using an arguably exogenous variation at this cutoff, I find that Medicaid enrollment increases for childless adults. This leads to an employment transition from full-time (≥35 Hrs) to part-time employment (\u3c35 Hrs) after the expansion. The employment transition is mainly driven by the increase in employment for working less than 20 hours. These findings support the presence of employment lock -- individuals who are employed primarily to retain health benefits. Replication of existing studies that used difference-in-differences (DD) models with expansion states as the treatment yield no employment effects. The treatment group in these models, however, is large and heterogeneous.In the second chapter, I assess the effect of the ACA\u27s Medicaid expansion on the retirement decision of low-income adults aged 55 to 64 years. This chapter also focuses on childless adults, a group that gained access to Medicaid coverage after the ACA. Using an instrumental variables (IV) model that exploits both the expansion decision of states and timing, I find that the probability of retirement increases by 14.8 percentage points for childless adults with Medicaid. The probability of retirement increases by 13.4 and 16.1 percentage points for men and women, respectively

The Relationship Between Health Insurance and Early Retirement: Evidence from the Affordable Care Act

Retirement_SavingsBeginning with the first round of the Affordable Care Act’s Medicaid expansions, which specifically targeted low-income adults without dependent children, the uninsured rate reached a record low in 2015. However, the spillover effects of the Medicaid expansion, such as the relationship between health insurance and labor supply, have become a point of interest for both researchers and policy makers alike. In working paper 1807, PERC postdoctoral research associate Erkmen Giray Aslim investigates whether the increased availability of Medicaid through the ACA’s expansions affects the retirement decisions of targeted workers. Among low-income childless adults, findings show that the expansions increased Medicaid enrollment for both men and women, and that enrollment resulted in women retiring early, whereas no significant change was observed for men

Fiscal Decentralization, Political Heterogeneity and Welfare

PoliticalEconomyTheoretical and empirical literature on �scal decentralization has been thriving, while understanding the welfare implications of �scal decentralization under political diversity necessitates further investigation. Authors Erkmen G. Aslim and co-author Bilin Neyapti contribute to this literature by formally modeling the interaction between the central government and local governments, where the latter may have varying degrees of political proximity to the former. The model solution reveals that the optimal tax rate is positively associated with �scal decentralization, political unison, and spillovers across localities, while the local tax collection effort is negatively associated with all of these parameters. The �rst novel �nding of this study is that both the welfare and the central government’s utility peak and income distribution is more equitable at a lower level of �scal decentralization when spillovers exist than otherwise, which supports the decentralization theorem. The second novel �nding is that both the amount of redistributable income and central government utility increases with political unison

The Relationship Between Health Insurance and Early Retirement: Evidence from the Affordable Care Act

MacroeconomicsAs the Affordable Care Act (ACA) recently expanded Medicaid coverage to low-income childless adults, the uninsured rate reached a record low in 2015. In contrast, large firms with 200 or more employees are continuing to cut retiree benefits. With Medicaid as a new alternative to early retiree health insurance, it is important to understand the effects of the ACA’s Medicaid expansion on early retirement. This article summarizes working paper 1807, where PERC researcher Erkmen Giray Aslim studies the effect of the Affordable Care Act’s Medicaid expansion on the decision to retire

Does Maternity Leave Duration Affect Labor Force Participation and Productivity?

PoliticalEconomyGiven the extensively documented evidence that increases in female labor force participation rate are beneficial for the economy in the long run, a natural question that arises in this context is whether policy changes can affect female labor force participation. In this paper coauthored by Erkmen Giray Aslim, Irina Panovska and M. Anil Tas, the authors explore to what extent maternity leave affects female and male labor force participation, and to what extent changes in duration of maternity leave directly affect productivity. Using narrative evidence that identifies the exact dates when legislative changes to maternity leave policies were enacted and enforced, the authors build a comprehensive maternity leave data for a panel of middle and high-income countries with emerging financial markets. Findings show that maternity leave has positive but limited effects on female labor force participation, but it signi�cantly increases male labor force participation. There is some evidence that increases in maternity leave duration decrease productivity in the short run, but there are no signi�cant adverse effects in the intermediate run. The authors also find evidence of substitutability between male and female workers and strong evidence in favor of a nonlinear relationship between GDP per capita and labor force participation

From Syringes to Dishes: Improving Food Security through Vaccination

This paper examines the impact of COVID-19 vaccination on food insecurity in the United States, using data from the Household Pulse Survey. Our primary research design exploits variation in vaccine eligibility across states over time as an instrumental variable to address the endogeneity of vaccination decision. We find that vaccination had a substantial impact on food hardship by reducing the likelihood of food insecurity by 24%, with even stronger effects among minority and financially disadvantaged populations. Our results are robust to alternative specifications and the use of regression discontinuity as an alternative identification strategy. We also show that vaccine eligibility had a positive spillover impact on food assistance programs, specifically by reducing participation in the Supplemental Nutrition Assistance Program (SNAP), which suggests that vaccination policy can be effective in alleviating the fiscal burden of the pandemic on the government. Furthermore, our analysis indicates that vaccinated individuals exhibit increased financial optimism, as measured by expectations about future loss of employment and income as well as ability to make mortgage and debt payments. Based on the point estimates, the implied elasticity of food insecurity with respect to financial optimism is between -0.57 and -0.86. Our findings suggest that the COVID-19 vaccination program has implications that extend beyond the direct health benefits. Taken together, our results underscore the critical role of medical innovations and health interventions in improving economic optimism and food security, especially among vulnerable populations, during public health crises