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The Effect of the Minimum Wage on Employer-Sponsored Insurance for Low-Income Workers and Dependents 最低工资对雇主赞助的低收入工人和家属保险的影响
IF 3.7 2区 经济学 Q1 Economics, Econometrics and Finance Pub Date : 2021-07-06 DOI: 10.1086/716198
M. Dworsky, C. Eibner, Xiaoyu Nie, J. Wenger
Economic theory suggests that a binding minimum wage increase may reduce the generosity of employer-sponsored insurance (ESI) or other fringe benefits, yet previous empirical studies reach conflicting conclusions about the existence of a trade-off between minimum wages and ESI. We study whether recent state and federal minimum wage increases affect the level or the source of health insurance coverage for low-income families using the 2005–16 Current Population Survey. Our research design uses state and year fixed effects to isolate within-state minimum wage changes while controlling for Medicaid eligibility and other changes in health policy related to implementation of the Affordable Care Act. Because dependent coverage might also be affected by minimum wage hikes, we examine ESI coverage for both low-wage workers and their dependents. We find robust evidence that minimum wage increases lead to reductions in ESI coverage in families below 300 percent of the federal poverty level, with a nominal $1 increase in the minimum wage reducing the probability of ESI coverage by 0.99 percentage points. Reductions in coverage were observed both for workers and for their dependents.
经济理论表明,具有约束力的最低工资增长可能会降低雇主赞助保险(ESI)或其他附加福利的慷慨程度,但之前的实证研究得出了关于最低工资与ESI之间存在权衡的矛盾结论。我们使用2005-16年当前人口调查来研究最近的州和联邦最低工资增长是否影响低收入家庭健康保险覆盖的水平或来源。我们的研究设计使用州和年度固定效应来隔离州内最低工资的变化,同时控制医疗补助资格和与实施《平价医疗法案》相关的健康政策的其他变化。由于受抚养人的覆盖范围也可能受到最低工资上涨的影响,我们研究了低工资工人及其受抚养人的ESI覆盖范围。我们发现强有力的证据表明,最低工资的增加会导致低于联邦贫困水平300%的家庭ESI覆盖率下降,最低工资每名义上增加1美元,ESI覆盖率的可能性就会降低0.99个百分点。工人及其家属的保险范围都有所减少。
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引用次数: 3
Consumer Responses to Firms’ Voluntary Disclosure of Information 消费者对企业自愿披露信息的反应
IF 3.7 2区 经济学 Q1 Economics, Econometrics and Finance Pub Date : 2021-07-01 DOI: 10.1086/722269
R. Avery, J. Cawley, Julia C. P. Eddelbuettel, Matthew D. Eisenberg, Charlie Mann, A. Mathios
This paper estimates the impact on consumer behavior of a firm’s voluntary disclosure of information. Specifically, we study the impact of Starbucks’ disclosure of calorie information on its menu boards in June 2013. Using a large data set of consumers’ visits to specific restaurant chains, we estimate difference-in-difference models that compare the change in the probability that consumers recently visited Starbucks with the change in the probability that they recently visited a similar chain that did not disclose calorie information: Dunkin’ Donuts. Estimates from difference-in-differences models indicate that we cannot reject the null hypothesis that Starbucks’ disclosure of calorie information had no detectable impact on the probability that consumers patronized Starbucks in the past month. However, we find an effect among men; after Starbucks’ information disclosure, the probability that men visit the chain fell by 1.0 percentage points (10.7 percent). There is no evidence of heterogeneity in effect by education or clinical weight classification. These results are useful for understanding how consumers respond to the voluntary disclosure of information, a decision many firms face.
本文估计了企业自愿披露信息对消费者行为的影响。具体而言,我们研究了2013年6月星巴克在其菜单板上披露卡路里信息的影响。使用消费者访问特定连锁餐厅的大量数据集,我们估计了差异模型的差异,该模型将消费者最近访问星巴克的概率变化与他们最近访问未披露卡路里信息的类似连锁店Dunkin’Donuts的概率变化进行了比较。差异模型的估计表明,我们不能拒绝星巴克披露卡路里信息对消费者在过去一个月光顾星巴克的概率没有明显影响的无效假设。然而,我们在男性中发现了一种影响;星巴克信息披露后,男性光顾该连锁店的概率下降了1.0个百分点(10.7%)。没有证据表明教育或临床体重分类的效果存在异质性。这些结果有助于了解消费者对自愿披露信息的反应,这是许多公司面临的决定。
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引用次数: 2
Do Policies to Increase Access to Treatment for Opioid Use Disorder Work? 增加阿片类药物使用障碍治疗机会的政策有效吗?
IF 3.7 2区 经济学 Q1 Economics, Econometrics and Finance Pub Date : 2021-07-01 DOI: 10.1086/722980
E. Barrette, Leemore S. Dafny, Karen Shen
Even among commercially insured individuals, opioid use disorder is undertreated in the United States: nearly half receive no treatment within six months of a new diagnosis. Using a difference-in-differences specification exploiting the extension of insurance parity requirements for substance use disorder treatment to small-group enrollees in 2014, we find that parity increases utilization of residential treatment but decreases utilization of agonist medications, the standard of care. We find direct interventions to increase access to medication may be more promising: increases in the county-level share of physicians able to prescribe agonists are associated with substitution toward treatment that includes medication.
即使在商业保险的个人中,阿片类药物使用障碍在美国也治疗不足:近一半的人在新诊断的六个月内没有得到治疗。使用差异说明,利用2014年将药物使用障碍治疗的保险平价要求扩展到小群体参与者,我们发现平价增加了住院治疗的利用率,但降低了激动剂药物(护理标准)的利用率。我们发现,增加药物获取的直接干预措施可能更有希望:能够开激动剂的县级医生比例的增加与包括药物在内的治疗的替代有关。
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引用次数: 3
The Ohio Vaccine Lottery and Starting Vaccination Rates 俄亥俄州疫苗彩票和起始疫苗接种率
IF 3.7 2区 经济学 Q1 Economics, Econometrics and Finance Pub Date : 2021-06-27 DOI: 10.1086/718512
Margaret E. Brehm, Paul A. Brehm, Martin Saavedra
We find that Ohio’s “Vax-a-Million” lottery increased first-dose COVID-19 vaccinations by between 50,000 and 100,000, with most of the additional doses occurring during the two weeks between the announcement and the first lottery drawing. We use county-level data and two empirical approaches to provide causal estimates of the lottery in Ohio. First, a difference-in-differences design compares vaccination rates in border counties in Ohio and Indiana before and after the announcement. Second, we use a pooled synthetic control method to construct a counterfactual for each of Ohio’s counties using control counties in Indiana, Michigan, and Pennsylvania. The synthetic control analysis reveals larger increases in vaccination rates in more populous counties. Our estimates imply that Ohio paid about $75 per additional starting dose during this period.
我们发现,俄亥俄州的“百万Vax-a-Million”彩票将第一剂新冠肺炎疫苗接种增加了5万至10万剂,其中大部分额外接种发生在宣布和第一次彩票抽奖之间的两周内。我们使用县级数据和两种实证方法来提供俄亥俄州彩票的因果估计。首先,差异设计比较了俄亥俄州和印第安纳州边境县在宣布之前和之后的疫苗接种率。其次,我们使用混合综合控制方法,使用印第安纳州、密歇根州和宾夕法尼亚州的控制县,为俄亥俄州的每个县构建反事实。综合对照分析显示,在人口较多的县,疫苗接种率有更大的增长。我们的估计表明,在此期间,俄亥俄州每增加一剂起始剂量就支付约75美元。
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引用次数: 32
What to Expect When It Gets Hotter 天气变热时的预期
IF 3.7 2区 经济学 Q1 Economics, Econometrics and Finance Pub Date : 2021-06-01 DOI: 10.1086/714359
Jiyoon Kim, Ajin Lee, Maya Rossin-Slater
We use temperature variation within narrowly defined geographic and demographic cells to show that exposure to extreme temperature increases the risk of maternal hospitalization during pregnancy. This effect is driven by emergency hospitalizations for various pregnancy complications, suggesting that it represents a deterioration in underlying maternal health rather than a change in women’s ability to access health care. The effect is larger for black women than for women of other races, suggesting that without significant adaptation, projected increases in extreme temperatures over the next century may further exacerbate racial disparities in maternal health.
我们使用狭义地理和人口统计细胞内的温度变化来显示暴露于极端温度会增加孕妇在怀孕期间住院的风险。这种影响是由各种妊娠并发症的紧急住院造成的,这表明它代表了潜在的孕产妇健康恶化,而不是妇女获得保健的能力发生了变化。这种影响对黑人妇女的影响大于对其他种族妇女的影响,这表明,如果不进行重大适应,预计下个世纪极端温度的增加可能会进一步加剧孕产妇保健方面的种族差异。
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引用次数: 11
Hospital Avoidance and Unintended Deaths during the COVID-19 Pandemic COVID-19大流行期间的住院回避和意外死亡
IF 3.7 2区 经济学 Q1 Economics, Econometrics and Finance Pub Date : 2021-05-04 DOI: 10.1086/715158
Jonathan Zhang
The COVID-19 pandemic significantly altered individual behaviors, including the consumption of health care. I study utilization and mortality in the largest integrated health-care system in the United States, the Veterans Health Administration, and find that between the middle of March and the beginning of May 2020, emergency department and inpatient hospital visits declined by 37 percent and 46 percent, and remained 10 percent and 17 percent below expected levels by the end of October. Declines were more pronounced for nonurgent and non-life-threatening conditions, although urgent and life-threatening conditions also dropped by a quarter during the early months. Conditional on arrival at the emergency department, conditions were more severe at presentation. In the first two months of the pandemic, veteran mortality increased by 19.5 percent, yet non-COVID-19 mortality in VA inpatient settings declined. I find suggestive evidence that hospital avoidance may have resulted in higher non-COVID-19 mortality. By focusing on counties with no official COVID-19 deaths by May 19, 2020, I estimate that an upper bound of 7.9 percent of excess veteran deaths in the first two months of the pandemic were due to hospital avoidance.
新冠肺炎大流行显著改变了个人行为,包括医疗保健的消费。我研究了美国最大的综合医疗保健系统退伍军人健康管理局的利用率和死亡率,发现从2020年3月中旬到5月初,急诊科和住院医院的就诊人数分别下降了37%和46%,到10月底仍比预期水平低10%和17%。非紧急和无生命危险的情况下降更为明显,尽管紧急和危及生命的情况在最初几个月也下降了四分之一。在到达急诊室时,情况更为严重。在大流行的前两个月,退伍军人死亡率增加了19.5%,但弗吉尼亚州住院患者的非COVID-19死亡率有所下降。我发现有提示性证据表明,避免住院可能导致了更高的非COVID-19死亡率。通过将重点放在2020年5月19日之前没有官方新冠肺炎死亡病例的县,我估计在大流行的前两个月,退伍军人死亡人数的上限为7.9%是由于避免住院。
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引用次数: 17
Tiered Cost-Sharing for Primary Care Gatekeeper Clinics 初级保健看门人诊所的分层费用分担
IF 3.7 2区 经济学 Q1 Economics, Econometrics and Finance Pub Date : 2021-03-17 DOI: 10.1086/714360
B. Dowd, Tsan-Yao Huang, T. McDonald
Efforts to improve the efficiency of the US health-care system involve both provider payment reform and efforts to give consumers the information they need to choose efficient providers and a financial incentive to do so. An example of the latter type of initiative is tiered cost-sharing. We analyze data from a long-standing tiered cost-sharing system for primary care gatekeeper clinics. These clinics control access to specialists and hospitals and are held accountable for their patients’ total annual risk-adjusted spending on covered health-care services. Consumers choosing higher cost clinics face higher levels of deductibles, copayments, and out-of-pocket maximums. We find that when choosing a primary care clinic, consumers are responsive to the clinic’s tier. Consumers exhibit a high level of inertia, but nonetheless, many clinics voluntarily reduce their fees to move to, or retain placement in, lower cost tiers.
提高美国医疗保健系统效率的努力既包括提供者支付改革,也包括向消费者提供选择高效提供者所需的信息,以及为此提供经济激励。后一类举措的一个例子是分级成本分担。我们分析了长期以来初级保健看门人诊所的分层成本分担系统的数据。这些诊所控制着获得专家和医院的机会,并对患者在覆盖的医疗服务上的年度风险调整支出总额负责。选择高成本诊所的消费者面临更高水平的免赔额、自付额和自付最高限额。我们发现,在选择初级保健诊所时,消费者对诊所的级别有反应。消费者表现出高度的惰性,但尽管如此,许多诊所还是自愿降低费用,以转移到或保留在成本较低的级别。
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引用次数: 6
Health Insurance Coverage in Tax and Survey Data 税收和调查数据中的健康保险覆盖范围
IF 3.7 2区 经济学 Q1 Economics, Econometrics and Finance Pub Date : 2021-03-01 DOI: 10.1086/712213
I. Lurie, James E. Pearce
The Current Population Survey provides official estimates of the number of people covered by health insurance and the number of uninsured in the United States. This type of survey data are also used to study the effects of policy changes on health insurance coverage. However, there is evidence that individuals sometimes misreport health insurance coverage, which might bias findings that use survey data. We use new administrative health insurance information from tax data to evaluate health insurance coverage in survey data across several dimensions, including age, income, and state. Our main findings suggest that although overall coverage counts are similar between survey and administrative data across all demographic characteristics, coverage rates and uninsured counts differ because of differences in population size. These similarities mask coverage differences by insurance type. Medicaid coverage is very well reported in tax data, whereas surveys tend to underreport it, especially for low-income individuals and people under the age of 40. Employer-sponsored coverage counts are higher in survey data than in administrative data. Finally, this study provides researchers that use survey data a benchmark for how to adjust Medicaid coverage to align with administratively reported levels.
当前人口调查提供了美国健康保险覆盖人数和未保险人数的官方估计。这类调查数据也用于研究政策变化对健康保险覆盖面的影响。然而,有证据表明,个人有时会误报健康保险覆盖范围,这可能会使使用调查数据的结果产生偏差。我们使用来自税务数据的新的行政健康保险信息,跨几个维度评估调查数据中的健康保险覆盖范围,包括年龄、收入和州。我们的主要发现表明,尽管在所有人口特征中,调查数据和行政数据的总体覆盖率是相似的,但由于人口规模的差异,覆盖率和未参保人数有所不同。这些相似之处掩盖了不同保险类型承保范围的差异。医疗补助覆盖范围在税收数据中得到了很好的报告,而调查往往会少报,尤其是对低收入个人和40岁以下的人。雇主赞助的覆盖率在调查数据中比在行政数据中更高。最后,本研究为使用调查数据的研究人员提供了如何调整医疗补助覆盖范围以与行政报告水平保持一致的基准。
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引用次数: 10
Pandemics, Protests, and Firearms 流行病、抗议和枪支
IF 3.7 2区 经济学 Q1 Economics, Econometrics and Finance Pub Date : 2021-03-01 DOI: 10.1086/713035
Bree J. Lang, Matthew Lang
A record number of firearm background checks were completed at the onset of the COVID-19 pandemic and during the protests following the murder of George Floyd. Using monthly state-level data, we show that the increase in firearm background check rates in March 2020 and June 2020 differ from previous gun-buying events in at least two important ways. First, the increases in the background check rates surrounding COVID-19 and the George Floyd protests are significantly larger than previous gun-buying events. Second, the gun-buying events of 2020 are nonpartisan; the effect in Republican-leaning states is statistically indistinguishable from the effect in Democrat-leaning states. Our estimates suggest that there were 62 percent more background checks completed between March and August 2020 than expected, which amounts to over 7 million additional background checks. We provide evidence that the recent spikes in background checks are not motivated by gun policy uncertainty and discuss policy recommendations that may alleviate any negative outcomes associated with expanded gun ownership during an unprecedented pandemic.
在新冠肺炎大流行开始时以及在乔治·弗洛伊德被谋杀后的抗议活动中,完成了创纪录数量的枪支背景调查。使用月度州级数据,我们发现,2020年3月和2020年6月枪支背景调查率的上升至少在两个重要方面与之前的枪支购买事件不同。首先,围绕新冠肺炎和乔治·弗洛伊德抗议活动的背景调查率的上升幅度明显大于之前的持枪事件。其次,2020年的枪支购买事件是无党派的;从统计数据来看,倾向共和党的州的影响与倾向民主党的州的效果难以区分。我们的估计表明,2020年3月至8月期间完成的背景调查比预期多62%,相当于增加了700多万次背景调查。我们提供的证据表明,最近背景调查的激增并非出于枪支政策的不确定性,并讨论了可能缓解在前所未有的疫情期间扩大枪支所有权带来的任何负面后果的政策建议。
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引用次数: 13
COVID-19 and Crime 新冠肺炎与犯罪
IF 3.7 2区 经济学 Q1 Economics, Econometrics and Finance Pub Date : 2021-02-02 DOI: 10.1086/713787
L. Bullinger, J. Carr, Analisa Packham
COVID-19 has led to an abrupt change in time spent at home, with many cities and states implementing official stay-at-home (SAH), or “lockdown,” policies. Using cell phone block-level activity data and administrative 911 and crime data from the City of Chicago, we estimate the effects of the Illinois governor’s SAH order on calls for police service, crimes recorded by police, and arrests made relating to domestic violence. We find that the SAH order announcement increased time spent at home, leading to a decrease in total calls for police service, but a subsequent increase in domestic violence–related calls for police service. However, we find that official reports by police officers and arrests for domestic violence crimes fell by 6.8 percent and 26.4 percent, respectively. Declines in reported domestic violence crimes mirror drops in total reported crimes; however, the reduction for domestic violence crimes is around 5 times smaller than the decline in overall crime rates.
新冠肺炎导致在家的时间突然改变,许多城市和州实施了官方的居家(SAH)或“封锁”政策。利用芝加哥市的手机封锁级别的活动数据、行政911和犯罪数据,我们估计了伊利诺伊州州长的SAH命令对报警电话、警方记录的犯罪以及与家庭暴力有关的逮捕的影响。我们发现,SAH命令的宣布增加了在家的时间,导致报警电话总数减少,但随后与家庭暴力相关的报警电话增加。然而,我们发现,警察的官方报告和对家庭暴力犯罪的逮捕分别下降了6.8%和26.4%。报告的家庭暴力犯罪的下降反映了报告的犯罪总数的下降;然而,家庭暴力犯罪的减少幅度大约是整体犯罪率下降幅度的5倍。
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引用次数: 56
期刊
American Journal of Health Economics
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