Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low Income Children

Despite intensive scrutiny, the effects of Medicaid expansions on the health insurance status of low-income children remain controversial. We re-examine the effects of the two largest federally-mandated expansions which offered Medicaid coverage to low-income children in specific age ranges and birth cohorts. We use a regression discontinuity approach, comparing Medicaid enrollment, private insurance coverage, and overall insurance coverage on either side of the age limits of the laws. We conclude that the modest impacts of the expansions on health insurance coverage arose because of very low takeup rates of the newly available coverage, rather than from crowd-out of private insurance coverage.

Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low Income Children

This paper exploits the discrete nature of the eligibility criteria for two major federal expansions of Medicaid to measure the effects on Medicaid coverage, overall health insurance coverage, and the probability of visiting a doctor. The '100 percent' expansion, effective in 1991, extended Medicaid eligibility to children born after September 30, 1983 in families below the poverty line. We estimate that this law led to about a 10 percentage point rise in Medicaid coverage for children born just after the cutoff date, and a similar or slightly smaller rise in overall health insurance. It also increased the fraction of children in the newly eligible group with a doctor visit in the previous year. The '133 percent' expansion, effective in 1990, extended Medicaid to children under 6 in families with incomes below 133 percent of the poverty line. This law had relatively small effects on Medicaid coverage for children near the eligibility limits, and little or no effect on health insurance coverage.

Non-universal coarsening and universal distributions in far-from equilibrium systems

Anomalous coarsening in far-from equilibrium one-dimensional systems is investigated by simulation and analytic techniques. The minimal hard core particle (exclusion) models contain mechanisms of aggregated particle diffusion, with rates epsilon<<1, particle deposition into cluster gaps, but suppressed for the smallest gaps, and breakup of clusters which are adjacent to large gaps. Cluster breakup rates vary with the cluster length x as kx^alpha. The domain growth law x ~ (epsilon t)^z, with z=1/(2+alpha) for alpha>0, is explained by a scaling picture, as well as the scaling of the density of double vacancies (at which deposition and cluster breakup are allowed) as 1/[t(epsilon t)^z]. Numerical simulations for several values of alpha and epsilon confirm these results. An approximate factorization of the cluster configuration probability is performed within the master equation resulting from the mapping to a column picture. The equation for a one-variable scaling function explains the above results. The probability distributions of cluster lengths scale as P(x)= 1/(epsilon t)^z g(y), with y=x/(epsilon t)^z. However, those distributions show a universal tail with the form g(y) ~ exp(-y^{3/2}), which disagrees with the prediction of the independent cluster approximation. This result is explained by the connection of the vacancy dynamics with the problem of particle trapping in an infinite sea of traps and is confirmed by simulation.Comment: 30 pages (10 figures included), to appear in Phys. Rev.

The Effect of Medicaid Expansions for Low-Income Children on Medicaid Participation and Private Insurance Coverage : Evidence from the SIPP

We examine Medicaid enrollment and private coverage loss following expansions of Medicaid eligibility. We attempt to replicate Cutler and GruberÂ’s (1996) results using the Survey of Income and Program Participation, and find smaller rates of take-up and little evidence of crowding out. We find that some of the difference in results can be attributed to different samples and recall periods in the data sets used. Extending the previous literature, we find that take-up is slightly increased if a childÂ’s siblings are eligible and with time spent eligible. Focusing on children whose eligibility status changes during the sample, we estimate smaller take-up effects. We find little evidence of crowding out in any of our extensions.

Did Expanding Medicaid Affect Welfare Participation?

Using data from the 1988-1996 Current Population Surveys (CPS), we re-examine the evidence presented in Yelowitz (1995) showing that expansions in Medicaid eligibility for children were associated with increased labor force participation and reduced participation in Aid to Families with Dependent Children (AFDC) among single mothers. We find that Yelowitz's results were the result of two factors. First, he imposed a strong restriction on the parameter estimates that is not predicted by theory and is rejected in the CPS data. Second, he used only one of the two income tests that families must pass to be eligible for AFDC, resulting in higher imputed AFDC breakeven income levels for larger families. Once these problems are addressed, the Medicaid income limits have no significant effect on AFDC participation. The AFDC income limits, however, are significantly related to welfare and labor force participation in both his original sample and the entire 1988-1996 sample.

The Impact of Public Health Insurance on Labor Market Transitions

An often-cited difficulty with moving low-income families out of welfare and into the labor force is the lack of health insurance in many low-wage jobs. Consequently, many low-income household heads may be reluctant to leave welfare and thereby lose health insurance coverage for their children. The expansions in the Medicaid program to cover low-income children and pregnant women who are not eligible for cash benefits may help alleviate the problem by allowing disadvantaged household heads to accept jobs which do not provide health insurance. We use a discrete time (monthly) hazard rate model and data from several panels of the Survey of Income and Program Participation to assess whether expansion of public health insurance to cover children of working parents contributes to increase transitions out of welfare and into employment and reduce transitions into welfare and out of employment. We model spells in progress and spells that start during the sample separately, which allows us to assess the effect on long-term welfare recipients. We find some evidence that expanded Medicaid eligibility for children leads single mothers to exit welfare more quickly; however the effects are not robust to the inclusion of year effects. In addition, the effect appears to be strongest and most consistent among long-term recipients (as proxied by recipients who begin the sample on welfare). We find less evidence of an effect of expanded Medicaid eligibility on transitions into welfare. A somewhat surprising finding is that higher AFDC income limits also appear to have little effect on the probability of such transitions.

The Effect of Medicaid Expansions for Low-Income Children on Medicaid Participation and Insurance Coverage: Evidence from the SIPP

Increased availability of public health insurance for children has led to two potentially contradictory concerns for public policy: that expanded availability of public insurance may lead families to decline private insurance and that additional public coverage may not reach many uninsured children. We examine these two concerns using data from the 1987-1993 Surveys of Income and Program Participation. Using static models we find that the expansions resulted in increased Medicaid coverage, although the estimates of take-up are smaller than estimates from previous research. We find little evidence of a negative relationship of any significant magnitude between eligibility for Medicaid and private coverage. We also find that children who have been eligible for Medicaid longer are more likely to be enrolled in Medicaid but no more likely to have lost private coverage. Including individual fixed effects reduces the magnitude of the estimated take-up effect, while the fixed effects estimates for the private insurance regression become negative and marginally statistically significant in some specifications. Simple dynamic models of insurance choice show that insurance choice is quite persistent. The estimated long run impact of eligibility in the dynamic models is larger than the estimate from the static models, while the immediate impact of expanded Medicaid eligibility from the dynamic models is smaller than the estimated effect from the static models.

Stimulated Raman adiabatic passage analogs in classical physics

Stimulated Raman adiabatic passage (STIRAP) is a well established technique for producing coherent population transfer in a three-state quantum system. We here exploit the resemblance between the Schrodinger equation for such a quantum system and the Newton equation of motion for a classical system undergoing torque to discuss several classical analogs of STIRAP, notably the motion of a moving charged particle subject to the Lorentz force of a quasistatic magnetic field, the orientation of a magnetic moment in a slowly varying magnetic field, the Coriolis effect and the inertial frame dragging effect. Like STIRAP, those phenomena occur for counterintuitively ordered field pulses and are robustly insensitive to small changes in the interaction properties

Tuning the stochastic background of gravitational waves using the WMAP data

The cosmological bound of the stochastic background of gravitational waves is analyzed with the aid of the WMAP data, differently from lots of works in literature, where the old COBE data were used. From our analysis, it will result that the WMAP bounds on the energy spectrum and on the characteristic amplitude of the stochastic background of gravitational waves are greater than the COBE ones, but they are also far below frequencies of the earth-based antennas band. At the end of this letter a lower bound for the integration time of a potential detection with advanced LIGO is released and compared with the previous one arising from the old COBE data. Even if the new lower bound is minor than the previous one, it results very long, thus for a possible detection we hope in the LISA interferometer and in a further growth in the sensitivity of advanced projects.Comment: 9 pages, 2 figures, published in Modern Physics Letters A. arXiv admin note: substantial text overlap with arXiv:0901.119