Ordinarily, in federal practice, a plaintiff is master of the complaint. But the doctrine of "complete preemption," which affects certain federal laws, allows a defendant to recharacterize a plaintiff's state claims as being federal claims in disguise. An ordinary contract dispute, for instance, can transform into a pension battle, or a copyright action; and, thus recast, the lawsuit can be removed to federal court.The Puzzle of Panel Processing: ERISA, Complete Preemption, and the Federal Jurisdiction Gap traces, from its inception, the curious case of Sexton v. Panel Processing, which began as a state whistleblower suit and ended as a marquee Sixth Circuit decision about the Employee Retirement Income Security Act of 1974, the statutory behemoth more commonly known as ERISA. By tracing the path of Panel Processing and its odd procedural outcome, the piece highlights a possible gap between federal-question jurisdiction and the complete preemption process, a gap which has the potential to lead to unclear and frustrating jurisdictional outcomes at late stages of litigation. A modest tweak to federal practice-the sua sponte scrutiny of all removal notices premised on preemption doctrines-is proposed as the simplest practical solution to this problem.
{"title":"The Puzzle of Panel Processing: ERISA, Complete Preemption, and the Federal Jurisdiction Gap","authors":"David L. Goodwin","doi":"10.2139/ssrn.2698449","DOIUrl":"https://doi.org/10.2139/ssrn.2698449","url":null,"abstract":"Ordinarily, in federal practice, a plaintiff is master of the complaint. But the doctrine of \"complete preemption,\" which affects certain federal laws, allows a defendant to recharacterize a plaintiff's state claims as being federal claims in disguise. An ordinary contract dispute, for instance, can transform into a pension battle, or a copyright action; and, thus recast, the lawsuit can be removed to federal court.The Puzzle of Panel Processing: ERISA, Complete Preemption, and the Federal Jurisdiction Gap traces, from its inception, the curious case of Sexton v. Panel Processing, which began as a state whistleblower suit and ended as a marquee Sixth Circuit decision about the Employee Retirement Income Security Act of 1974, the statutory behemoth more commonly known as ERISA. By tracing the path of Panel Processing and its odd procedural outcome, the piece highlights a possible gap between federal-question jurisdiction and the complete preemption process, a gap which has the potential to lead to unclear and frustrating jurisdictional outcomes at late stages of litigation. A modest tweak to federal practice-the sua sponte scrutiny of all removal notices premised on preemption doctrines-is proposed as the simplest practical solution to this problem.","PeriodicalId":76903,"journal":{"name":"Employee benefits journal","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76021159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Official estimates of elderly poverty do not take into account either the medical needs of the elderly, which can be quite extensive, or the assets at their disposal, which may also be extensive. The new Supplemental Poverty Measure (SPM) explicitly takes into account medical needs but has been criticized for not concomitantly taking into account asset portfolios. In this paper we consider both jointly, using an approach adapted from a recent National Academy of Sciences report recommending methods for measuring poverty and medical risk while taking account of assets. We use longitudinal data from the Health and Retirement Study (HRS).
官方对老年人贫困的估计既没有考虑到老年人的医疗需求(这可能相当广泛)，也没有考虑到老年人可以支配的资产(这也可能很广泛)。新的补充贫困措施(SPM)明确考虑了医疗需求，但因没有同时考虑资产组合而受到批评。在本文中，我们综合考虑了这两者，采用了一种改编自美国国家科学院(National Academy of Sciences)最近一份报告的方法，该报告推荐了在考虑资产的情况下衡量贫困和医疗风险的方法。我们使用来自健康与退休研究(HRS)的纵向数据。
{"title":"Elderly Poverty in the United States in the 21st Century: Exploring the Role of Assets in the Supplemental Poverty Measure","authors":"Christopher Wimer, Lucas Manfield","doi":"10.2139/ssrn.2693201","DOIUrl":"https://doi.org/10.2139/ssrn.2693201","url":null,"abstract":"Official estimates of elderly poverty do not take into account either the medical needs of the elderly, which can be quite extensive, or the assets at their disposal, which may also be extensive. The new Supplemental Poverty Measure (SPM) explicitly takes into account medical needs but has been criticized for not concomitantly taking into account asset portfolios. In this paper we consider both jointly, using an approach adapted from a recent National Academy of Sciences report recommending methods for measuring poverty and medical risk while taking account of assets. We use longitudinal data from the Health and Retirement Study (HRS).","PeriodicalId":76903,"journal":{"name":"Employee benefits journal","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76581100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Chandra, Amy N. Finkelstein, Adam Sacarny, C. Syverson
The conventional wisdom in health economics is that idiosyncratic features of the healthcare sector leave little scope for market forces to allocate consumers to higher performance producers. However, we find robust evidence across a variety of conditions and performance measures that higher quality hospitals tend to have higher market shares at a point in time and expand more over time. Moreover, we find that the relationship between performance and allocation is stronger among patients who have greater scope for hospital choice, suggesting a role for patient demand in allocation in the hospital sector. Our findings suggest that the healthcare sector may have more in common with “traditional” sectors subject to standard market forces than is often assumed.
{"title":"Healthcare Exceptionalism? Performance and Allocation in the U.S. Healthcare Sector","authors":"A. Chandra, Amy N. Finkelstein, Adam Sacarny, C. Syverson","doi":"10.2139/ssrn.2698290","DOIUrl":"https://doi.org/10.2139/ssrn.2698290","url":null,"abstract":"The conventional wisdom in health economics is that idiosyncratic features of the healthcare sector leave little scope for market forces to allocate consumers to higher performance producers. However, we find robust evidence across a variety of conditions and performance measures that higher quality hospitals tend to have higher market shares at a point in time and expand more over time. Moreover, we find that the relationship between performance and allocation is stronger among patients who have greater scope for hospital choice, suggesting a role for patient demand in allocation in the hospital sector. Our findings suggest that the healthcare sector may have more in common with “traditional” sectors subject to standard market forces than is often assumed.","PeriodicalId":76903,"journal":{"name":"Employee benefits journal","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87151987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Brot-Goldberg, A. Chandra, B. Handel, Jonathan T. Kolstad
Measuring consumer responsiveness to medical care prices is a central issue in health economics and a key ingredient in the optimal design and regulation of health insurance markets. We study consumer responsiveness to medical care prices, leveraging a natural experiment that occurred at a large self-insured firm which required all of its employees to switch from an insurance plan that provided free health care to a non-linear, high deductible plan. The switch caused a spending reduction between 11.79%-13.80% of total firm-wide health spending. We decompose this spending reduction into the components of (i) consumer price shopping (ii) quantity reductions and (iii) quantity substitutions, finding that spending reductions are entirely due to outright reductions in quantity. We find no evidence of consumers learning to price shop after two years in high-deductible coverage. Consumers reduce quantities across the spectrum of health care services, including potentially valuable care (e.g. preventive services) and potentially wasteful care (e.g. imaging services). We then leverage the unique data environment to study how consumers respond to the complex structure of the high-deductible contract. We find that consumers respond heavily to spot prices at the time of care, and reduce their spending by 42% when under the deductible, conditional on their true expected end-of-year shadow price and their prior year end-of-year marginal price. In the first-year post plan change, 90% of all spending reductions occur in months that consumers began under the deductible, with 49% of all reductions coming for the ex ante sickest half of consumers under the deductible, despite the fact that these consumers have quite low shadow prices. There is no evidence of learning to respond to the true shadow price in the second year post-switch.
{"title":"What Does a Deductible Do? The Impact of Cost-Sharing on Health Care Prices, Quantities, and Spending Dynamics","authors":"Z. Brot-Goldberg, A. Chandra, B. Handel, Jonathan T. Kolstad","doi":"10.1093/QJE/QJX013","DOIUrl":"https://doi.org/10.1093/QJE/QJX013","url":null,"abstract":"Measuring consumer responsiveness to medical care prices is a central issue in health economics and a key ingredient in the optimal design and regulation of health insurance markets. We study consumer responsiveness to medical care prices, leveraging a natural experiment that occurred at a large self-insured firm which required all of its employees to switch from an insurance plan that provided free health care to a non-linear, high deductible plan. The switch caused a spending reduction between 11.79%-13.80% of total firm-wide health spending. We decompose this spending reduction into the components of (i) consumer price shopping (ii) quantity reductions and (iii) quantity substitutions, finding that spending reductions are entirely due to outright reductions in quantity. We find no evidence of consumers learning to price shop after two years in high-deductible coverage. Consumers reduce quantities across the spectrum of health care services, including potentially valuable care (e.g. preventive services) and potentially wasteful care (e.g. imaging services). We then leverage the unique data environment to study how consumers respond to the complex structure of the high-deductible contract. We find that consumers respond heavily to spot prices at the time of care, and reduce their spending by 42% when under the deductible, conditional on their true expected end-of-year shadow price and their prior year end-of-year marginal price. In the first-year post plan change, 90% of all spending reductions occur in months that consumers began under the deductible, with 49% of all reductions coming for the ex ante sickest half of consumers under the deductible, despite the fact that these consumers have quite low shadow prices. There is no evidence of learning to respond to the true shadow price in the second year post-switch.","PeriodicalId":76903,"journal":{"name":"Employee benefits journal","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81480746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The "Ultimate" Asset Protection Trust explores the world of pension plans and various types of pension plan designs. These retirement plans are primarily used for retirement, however they are protected from creditors under Federal Bankruptcy law. Pensions are covered in mystery as rules are confusing and only certain individuals such an Enrolled actuary may sign a schedule B on a 5500, the annual report used in a pension plan. Enrolled actuaries are few in number, today only about 4,000 in the United States compared with 1,340,000 attorneys and 2,000,000 who hold doctorate degrees. Hence, few individuals are aware of these plans. This paper provides a brief introduction into the world of pension plans and perhaps the "Ultimate" Asset Protection Trust - a Pension Trust.
{"title":"The 'Ultimate' Asset Protection Trust","authors":"Nicholas A. Paleveda","doi":"10.2139/SSRN.2655763","DOIUrl":"https://doi.org/10.2139/SSRN.2655763","url":null,"abstract":"The \"Ultimate\" Asset Protection Trust explores the world of pension plans and various types of pension plan designs. These retirement plans are primarily used for retirement, however they are protected from creditors under Federal Bankruptcy law. Pensions are covered in mystery as rules are confusing and only certain individuals such an Enrolled actuary may sign a schedule B on a 5500, the annual report used in a pension plan. Enrolled actuaries are few in number, today only about 4,000 in the United States compared with 1,340,000 attorneys and 2,000,000 who hold doctorate degrees. Hence, few individuals are aware of these plans. This paper provides a brief introduction into the world of pension plans and perhaps the \"Ultimate\" Asset Protection Trust - a Pension Trust.","PeriodicalId":76903,"journal":{"name":"Employee benefits journal","volume":"2009 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89867479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We study the factors that affect the utilization of health care services administered by the Department of Veterans Affairs (VA) and its racial differences. Due to data limitation, previous research in this regard mostly only focuses on veterans who are VA users or at least eligible for VA services. We fill in the gap in literature with a random sample of veterans 51 and older from the Health and Retirement Study. We find that, among all veterans, those who are black and less healthy are more likely to use VA health services. These factors, nevertheless, are no longer statistically significant after the sample is restricted to veterans who are eligible for VA services. We also find that VA health services and services provided through other channels are at least partial substitutes: VA usage drops when a veteran becomes age eligible for Medicare or when a veteran has health insurance coverage through employment. This drop in usage holds not only among all veterans, but also among veterans eligible for VA services. Finally, perception about the quality of services delivered in VA versus non-VA facilities strongly predicts VA services usage. Those who have favorable views toward VA use VA services more, and the results from variance decomposition suggests a majority part of the racial difference in VA usage can be attributed to the racial difference in such perception.
{"title":"Racial Difference in the Use of VA Health Services","authors":"Chichun Fang, K. Langa, Helen Levy, D. Weir","doi":"10.2139/ssrn.2738617","DOIUrl":"https://doi.org/10.2139/ssrn.2738617","url":null,"abstract":"We study the factors that affect the utilization of health care services administered by the Department of Veterans Affairs (VA) and its racial differences. Due to data limitation, previous research in this regard mostly only focuses on veterans who are VA users or at least eligible for VA services. We fill in the gap in literature with a random sample of veterans 51 and older from the Health and Retirement Study. We find that, among all veterans, those who are black and less healthy are more likely to use VA health services. These factors, nevertheless, are no longer statistically significant after the sample is restricted to veterans who are eligible for VA services. We also find that VA health services and services provided through other channels are at least partial substitutes: VA usage drops when a veteran becomes age eligible for Medicare or when a veteran has health insurance coverage through employment. This drop in usage holds not only among all veterans, but also among veterans eligible for VA services. Finally, perception about the quality of services delivered in VA versus non-VA facilities strongly predicts VA services usage. Those who have favorable views toward VA use VA services more, and the results from variance decomposition suggests a majority part of the racial difference in VA usage can be attributed to the racial difference in such perception.","PeriodicalId":76903,"journal":{"name":"Employee benefits journal","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80004143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Blundell, Rowena Crawford, Eric French, G. Tetlow
We use comparable data from the US and England to examine similarities and differences in the level and trajectories of assets among households aged 70 and over. We find that in the US assets on average decline gradually with age, while in England older households actually accumulate wealth. These differences appear to be driven largely, though not entirely, by housing wealth: over the period we consider house price growth drove increases in housing wealth in England that more than offset the slow draw down of non-housing wealth. This suggests the illiquid nature of housing is likely to be an important factor in explaining wealth drawdown at older ages. We also consider the potential importance of bequest motives and savings to insure against the risk of medical and long-term care expenses.
{"title":"Comparing Retirement Wealth Trajectories on Both Sides of the Pond","authors":"R. Blundell, Rowena Crawford, Eric French, G. Tetlow","doi":"10.2139/ssrn.2712341","DOIUrl":"https://doi.org/10.2139/ssrn.2712341","url":null,"abstract":"We use comparable data from the US and England to examine similarities and differences in the level and trajectories of assets among households aged 70 and over. We find that in the US assets on average decline gradually with age, while in England older households actually accumulate wealth. These differences appear to be driven largely, though not entirely, by housing wealth: over the period we consider house price growth drove increases in housing wealth in England that more than offset the slow draw down of non-housing wealth. This suggests the illiquid nature of housing is likely to be an important factor in explaining wealth drawdown at older ages. We also consider the potential importance of bequest motives and savings to insure against the risk of medical and long-term care expenses.","PeriodicalId":76903,"journal":{"name":"Employee benefits journal","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80160573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Israel Goldowitz, Garth Wilson, E. Kim, Kirsten Bender
The Pension Benefit Guaranty Corporation, the federal agency charged with insuring private-sector defined benefit pension plans, has long had a prominent role in corporate bankruptcies. PBGC focuses its effort on the continuation of pension plans, in true reorganizations and in sales of businesses. To this end, ERISA has made it more difficult for a sponsor to terminate a plan in its own economic interest. For example, a sponsor's latitude to terminate an underfunded plan was limited to circumstances involving the sponsor's financial distress. Likewise, the termination premium, which was added to ERISA in recent years, is an obligation that survives bankruptcy and it may help to deter some unwarranted terminations. Unfortunately, in some cases, PBGC must seek plan termination, and PBGC then seeks to maximize its recoveries. These are blunt tools, however, and the case law has further dulled them. With plan continuation the preferred outcome, PBGC succeeds in its statutory mission whenever a sponsor emerges from bankruptcy with its pension plan ongoing.
{"title":"The PBGC Wins a Case When the Debtor Keeps Its Pension Plan","authors":"Israel Goldowitz, Garth Wilson, E. Kim, Kirsten Bender","doi":"10.2139/SSRN.2716996","DOIUrl":"https://doi.org/10.2139/SSRN.2716996","url":null,"abstract":"The Pension Benefit Guaranty Corporation, the federal agency charged with insuring private-sector defined benefit pension plans, has long had a prominent role in corporate bankruptcies. PBGC focuses its effort on the continuation of pension plans, in true reorganizations and in sales of businesses. To this end, ERISA has made it more difficult for a sponsor to terminate a plan in its own economic interest. For example, a sponsor's latitude to terminate an underfunded plan was limited to circumstances involving the sponsor's financial distress. Likewise, the termination premium, which was added to ERISA in recent years, is an obligation that survives bankruptcy and it may help to deter some unwarranted terminations. Unfortunately, in some cases, PBGC must seek plan termination, and PBGC then seeks to maximize its recoveries. These are blunt tools, however, and the case law has further dulled them. With plan continuation the preferred outcome, PBGC succeeds in its statutory mission whenever a sponsor emerges from bankruptcy with its pension plan ongoing.","PeriodicalId":76903,"journal":{"name":"Employee benefits journal","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75007425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article describes Wisconsin worker's compensation law determining whether a workplace accident or occupational disease "arises out of employment." An accident, which occurs at one point of time, or a disease, which occurs over a period of time, may cause injury in innumerable ways; for example, an employee may sustain injury from an outside force, activity, or exposure to noise, fumes, or stress -- to name just a few potential hazards. In Wisconsin, the positional-risk doctrine, the usual-work rule, and the unusual-stress test determine when the cause of injury -- whether an accident or disease -- is considered to arise out of employment.
{"title":"Wisconsin Worker's Compensation: Arising Out of Employment","authors":"Eric W. Lengell","doi":"10.2139/SSRN.2638921","DOIUrl":"https://doi.org/10.2139/SSRN.2638921","url":null,"abstract":"This article describes Wisconsin worker's compensation law determining whether a workplace accident or occupational disease \"arises out of employment.\" An accident, which occurs at one point of time, or a disease, which occurs over a period of time, may cause injury in innumerable ways; for example, an employee may sustain injury from an outside force, activity, or exposure to noise, fumes, or stress -- to name just a few potential hazards. In Wisconsin, the positional-risk doctrine, the usual-work rule, and the unusual-stress test determine when the cause of injury -- whether an accident or disease -- is considered to arise out of employment.","PeriodicalId":76903,"journal":{"name":"Employee benefits journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73673822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-07-01DOI: 10.7208/9780226370507-003
T. Buchmueller, John C. Ham, Lara D. Shore-Sheppard
In both its costs and the number of its enrollees, Medicaid is the largest means-tested transfer program in the United States. It is also a fundamental part of the health care system, providing health insurance to low-income families, indigent seniors, disabled adults and, in some states, low-income adults more broadly. This paper reviews the history and structure of the Medicaid program and the large body of economic research that it has spawned in the nearly half century since it was established. We begin by summarizing the program’s history, goals and current rules. We then present program statistics, mainly related to enrollment and expenditures. Finally we turn to the research on the impact of Medicaid on a broad range of outcomes, discussing theoretical and methodological issues important for understanding these effects and reviewing the empirical literature, describing what has been learned thus far, investigating areas where studies seem to reach different conclusions and pointing to areas where we believe additional research would be fruitful.
{"title":"The Medicaid Program","authors":"T. Buchmueller, John C. Ham, Lara D. Shore-Sheppard","doi":"10.7208/9780226370507-003","DOIUrl":"https://doi.org/10.7208/9780226370507-003","url":null,"abstract":"In both its costs and the number of its enrollees, Medicaid is the largest means-tested transfer program in the United States. It is also a fundamental part of the health care system, providing health insurance to low-income families, indigent seniors, disabled adults and, in some states, low-income adults more broadly. This paper reviews the history and structure of the Medicaid program and the large body of economic research that it has spawned in the nearly half century since it was established. We begin by summarizing the program’s history, goals and current rules. We then present program statistics, mainly related to enrollment and expenditures. Finally we turn to the research on the impact of Medicaid on a broad range of outcomes, discussing theoretical and methodological issues important for understanding these effects and reviewing the empirical literature, describing what has been learned thus far, investigating areas where studies seem to reach different conclusions and pointing to areas where we believe additional research would be fruitful.","PeriodicalId":76903,"journal":{"name":"Employee benefits journal","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75738200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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