The effects of state EITC expansion on children’s health

This brief examines the impact of state-level adoption of Earned Income Tax Credits (EITCs) on a set of health-related outcomes for children, including: (1) health insurance coverage, (2) use of preventive medical and dental care, and (3) health status measures including maternal reports of child health and body mass index. It also considers the possibility that the effect of the EITC on these outcomes may vary depending on where a child lives; families in urban and rural communities have different access to medical care and other resources that promote good health. Author Reagan Baughman reports that the expansion of state EITCs is associated with lower rates of public health insurance coverage and greater rates of private health insurance coverage among children. In addition, implementation of a state EITC appears to be associated with a significant improvement in a child\u27s health status for children ages 11 to 14 as reported by the child\u27s mother

Low wages prevalent In direct care and child care workforce

The large-scale movement of women into the paid labor market has brought sweeping change into family life and also in who cares for the elderly and children. This brief studies workers in two low wage, predominantly female care-giving occupations plagued with high turnover, direct care workers and child care workers. It provides a better understanding of how they fare when compared with other female workers and discusses factors that contribute to their continued employment

Caring for America’s aging population: a profile of the direct-care workforce

Direct-care workers constitute a low-wage, high-turnover workforce with low levels of health insurance; taking these characteristics into account guides the challenge of how to deal with the growing demand for long-term care by an aging U.S. population

Labor Mobility of the Direct Care Workforce: Implications for the Provision of Long-Term Care

This study provides the first comprehensive analysis of the dynamics of labor supply of direct care workers, the lower-skill nursing workers who provide the bulk of long-term care for the elderly in the USA. Our estimates from the 1996 and 2001 panels of the Survey of Income and Program Participation (SIPP) show that the mean (median) duration of employment spells for the same direct care employer is only 9.7 (5.0) months. We find that fewer than one-third of direct care workers leave a job to take another job in the direct care field. There is also little indication of upward mobility in the health sector; direct care workers are approximately equally likely to transition to working as Registered Nurses as they are to working in household service jobs. Additionally, the rate at which spells end in work-limiting disability (5.4%) is very high compared with rates in similar occupations. We estimate duration models of direct care job spell length and find that, after correcting for the endogenous relationship between wages and tenure, wages appear to have a modest effect in preventing turnover; this effect is concentrated among the shortest spells

The Effect of Medicaid Wage Pass-Through Programs on the Wages of Direct Care Workers

Background: Despite growing demand for nursing and home health care as the US population ages, compensation levels in the low-skill nursing labor market that provides the bulk of long-term care remain quite low. The challenge facing providers of long-term care is that Medicaid reimbursement rates for nursing home and home health care severely restrict the wage growth that is necessary to attract workers, resulting in high turnover and labor shortages. Almost half of US states have responded by enacting “pass-through” provisions in their Medicaid programs, channeling additional long-term care funding directly to compensation of lower-skill nursing workers. Objectives: We test the effect of Medicaid wage pass-through programs on hourly wages for direct care workers. Research Design: We estimate several specifications of wage models using employment data from the 1996 and 2001 panels of the Survey of Income and Program Participation for nursing, home health, and personal care aides. The effect of pass-through programs is identified by an indicator variable for states with programs; 20 states adopted pass-throughs during the sample period. Results: Workers in states with pass-through programs earn as much as 12% more per hour than workers in other states after those programs are implemented. Conclusions: Medicaid wage pass-through programs appear to be a viable policy option for raising compensation levels of direct care workers, with an eye toward improving recruitment and retention in long-term care settings

Worker preferences, sorting and aggregate patterns of health insurance coverage

To assess the performance of the employment-based health insurance system, it is necessary to understand how well workers sort into jobs that offer their desired mix of cash wages relative to benefits. However, few studies directly measure the extent of sorting. We quantify the prevalence of mismatches between workers’ preferences and firms’ insurance offerings by considering two types of mismatch: (1) workers who appear to desire coverage through their employer, but work for firms that do not offer coverage, and; (2) workers who appear not to desire coverage through their employer, but work for firms that offer coverage. Most workers (79.6%) enjoy labor market matches that appear consistent with their preferences. The remaining 20.4% of workers appear to be mismatched. For most of these mismatches, the primary consequence is lower wages than would be earned if individuals were better matched in the labor market. However, a minority of the identified mismatches appear to be “involuntarily uninsured” workers who would gain insurance if they were to find a better match. Extrapolating from the analysis sample, these involuntarily uninsured workers and their uninsured dependents may represent up to one in six uninsured individuals in the United States. Copyright Springer Science+Business Media, LLC 2006Health insurance, Employment, Labour market, Sorting, Un insurance,