THE IMPACT OF MEDICARE PART D ON MORTALITY AND FINANCIAL STABILITY

Using the Health and Retirement Study Panel core files from 1996 to 2014, I analyze how Medicare Part D impacted access to prescription drug coverage by various demographic factors such as race, gender, and income. In Chapter 1, I find the highest take-up rates for those who were white, female, and with higher incomes. However, increases in coverage were high across the board, such that Medicare Part D also improved drug insurance coverage for those who were black, male, and with lower income. Thus, although Medicare Part D did increase prescription drug insurance coverage for seniors across the board, I also find potential for improvement in enrollment for difficult-to-reach groups. Next, Chapter 2 examines the impact of Medicare Part D on mortality. Although I do not find an impact on the life expectancy of respondents as a whole, I do find a significant positive effect for black respondents, indicating that Medicare Part D may have mattered more for disadvantaged groups. The largest impact is for black men, who have an additional 9 percentage point chance of living to age 73 for an additional 8 years of coverage (significant at the 5% level). When looking only at cardiovascular mortality, which is more likely to be influenced by drug coverage, I find improvements in life expectancy for the total population, with stronger effects for minorities and men. Overall, my findings suggest that Medicare Part D did move the needle on its goal: to improve the health of those who, without government intervention, had the most difficulty paying for prescription drugs. Chapter 3 looks at the impact of Medicare Part D prescription drug coverage on cost-related medication adherence, food insecurity, and finances among seniors. It would be reasonable to assume that Medicare Part D, which led to near-universal drug coverage among senior citizens, could allow seniors to shift money previously spent on drug expenditures to other areas. The strongest effect of Medicare Part D is on cost-related medication nonadherence, leading to a 21% decrease for an additional 8 years of Medicare Part D coverage. The impact is even stronger for the black male population (30%). I fail to reject the null hypothesis that Medicare Part D did not reduce food insecurity or household debt. Overall, Medicare Part D appears to have improved the financial stability of seniors

Federal Health Expenditures on Children on the Eve of Health Reform: A Benchmark for the Future

Analyzes trends in federal spending on children's health in 2010, changes over the past fifty years, factors that affect Medicaid and Children's Health Insurance Program coverage under the Affordable Care Act, and implications for federal spending

What's Been Happening to Charitable Giving Recently? A Look at the Data

Examines the impact of the recession on giving by individuals, foundations, bequests, and corporations; the effects of tax policy changes on individual giving and bequests; and the potential effects of capping the charitable deduction at 28 percent

How Targeted Are Federal Expenditures on Children? A Kids' Share Analysis of Expenditures by Income in 2009

Analyzes the distribution of government spending on children by family income; category, such as health, social services, and education; and program, such as Medicaid; and the extent to which it is targeted to low-income children. Considers implications