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Report
An Aggregate Model for Policy Analysis with Demographic Change
Prescott, Edward C.; McGrattan, Ellen R. (2016-08-11)
Many countries are facing challenging fiscal financing issues as their populations age and the number of workers per retiree falls. Policymakers need transparent and robust analyses of alternative policies to deal with demographic changes. In this paper, we propose a simple framework that can easily be matched to aggregate data from the national accounts. We demonstrate the usefulness of our framework by comparing quantitative results for our aggregate model with those of a related model that includes within-age-cohort heterogeneity through productivity differences. When we assess proposals ...
Staff Report , Paper 534

Working Paper
How Much Does Health Insurance Cost? Comparison of Premiums in Administrative and Survey Data
Splinter, David; Larrimore, Jeff (2018-05-04)
Using newly available administrative data from the Internal Revenue Service, this paper studies the distribution of employer-sponsored health insurance premiums. Previous estimates, in contrast, were almost exclusively from household surveys. After correcting for coverage limitations of the IRS data, we find that average premiums for employer-sponsored plans are roughly $1000 higher in IRS records than in the Current Population Survey. The downward bias in the CPS is largely driven by underestimating of premiums among married workers and topcoding of high premiums.
Finance and Economics Discussion Series , Paper 2018-030

Working Paper
Who Gets Medication-assisted Treatment for Opioid Use Disorder, and Does It Reduce Overdose Risk? Evidence from the Rhode Island All-payer Claims Database
Carman, Katherine Grace; Wen, Hefei; Yu, Hao; Wharam, James Frank; Sullivan, Riley; Burke, Mary A. (2021-02-01)
This paper uses the all-payer claims database (APCD) for Rhode Island to study three questions about the use of medication-assisted treatment (MAT) for opioid use disorder (OUD): (1) Does MAT reduce the risk of opioid overdose; (2) are there systematic differences in the uptake of MAT by observable patient-level characteristics; and (3) how successful were federal policy changes implemented in 2016 that sought to promote increased use of buprenorphine, one of three medication options within MAT? Regarding the first question, we find that MAT as practiced in Rhode Island is associated with a ...
Working Papers , Paper 21-3

Working Paper
Health Insurance as an Income Stabilizer
Blascak, Nathan; Roll, Stephen; Grinstein-Weiss, Michal; Gallagher, Emily (2020-01-29)
We evaluate the effect of health insurance on the incidence of negative income shocks using the tax data and survey responses of nearly 14,000 low income households. Us-ing a regression discontinuity (RD) design and variation in the cost of nongroup pri-vate health insurance under the Affordable Care Act, we find that eligibility for sub-sidized Marketplace insurance is associated with a 16% and 9% decline in the rates of unexpected job loss and income loss, respectively. Effects are concentrated among households with past health costs and exist only for “unexpected” forms of earnings ...
Working Papers , Paper 20-05

Working Paper
Reforming the US Long-Term Care Insurance Market
Braun, R. Anton; Kopecky, Karen A. (2024-08-14)
Nursing home risk is significant and costly. Yet, most Americans pay for long-term care (LTC) expenses out-of-pocket. This chapter examines reforms to both public and private LTCI provision using a structural model of the US LTCI market. Three policies are considered: universal public LTCI, no public LTCI coverage, and a policy that exempts asset holdings from the public insurance asset test on a dollar-for-dollar basis with private LTCI coverage. We find that this third reform enhances social welfare and creates a vibrant private LTCI market while preserving the safety net provided by public ...
Working Papers , Paper 24-17

Working Paper
How Important Is Health Inequality for Lifetime Earnings Inequality?
Hosseini, Roozbeh; Kopecky, Karen A.; Zhao, Kai (2021-01-04)
Using a dynamic panel approach, we provide empirical evidence that negative health shocks reduce earnings. The effect is primarily driven by the participation margin and is concentrated in less educated individuals and those with poor health. We build a dynamic, general equilibrium, life cycle model that is consistent with these findings. In the model, individuals whose health is risky and heterogeneous choose to either work, or not work and apply for social security disability insurance (SSDI). Health affects individuals’ productivity, SSDI access, disutility from work, mortality, and ...
FRB Atlanta Working Paper , Paper 2021-1

Working Paper
Health Insurance and Hospital Supply: Evidence from 1950s Coal Country
http://fedora:8080/fcrepo/rest/objects/authors/; http://fedora:8080/fcrepo/rest/objects/authors/ (2020-04-17)
The United States government spends billions on public health insurance and has funded a number of programs to build health care facilities. However, the government runs these two types of programs separately: in different places, at different times, and for different populations. We explore whether access to both health insurance and hospitals can improve health outcomes and access to health care. We analyze a coal mining union health insurance program in 1950s Appalachia with and without a complementary hospital construction program. Our results show that the union insurance alone increased ...
Finance and Economics Discussion Series , Paper 2020-033

Working Paper
Measuring Interest Rate Risk in the Life Insurance Sector: The U.S. and the U.K.
Rosen, Richard J.; Hartley, Daniel; Paulson, Anna L. (2016-01-03)
We use a two factor model of life insurer stock returns to measure interest rate risk at U.S. and U.K. insurers. Our estimates show that interest rate risk among U.S. life insurers increased as interest rates decreased to historically low levels in recent years. For life insurers in the U.K., in contrast, interest rate risk remained low during this time, roughly unchanged from what it was in the period prior to the financial crisis when long-term interest rates were in their usual historical ranges. We attribute these differences to the heavier use of products that combine guarantees with ...
Working Paper Series , Paper WP-2016-2

Report
The Affordable Care Act and the COVID-19 Pandemic: A Regression Discontinuity Analysis
Pinkovskiy, Maxim L.; Chakrabarti, Rajashri; Nober, William; Meyerson, Lindsay; Avtar, Ruchi (2020-11-01)
Did Medicaid expansion under the Affordable Care Act affect the course of the COVID-19 pandemic? We answer this question using a regression discontinuity design for counties near the borders of states that expanded Medicaid with states that did not. Relevant covariates change continuously across the Medicaid expansion frontier. We find that (1) health insurance changes discontinuously at the frontier, (2) COVID-19 testing is discontinuously larger in Medicaid-expanding states, and (3) the fraction of beds occupied in ICUs is discontinuously smaller in Medicaid-expanding states. We also find ...
Staff Reports , Paper 948

Discussion Paper
Investigating the Effect of Health Insurance in the COVID-19 Pandemic
Chakrabarti, Rajashri; Pinkovskiy, Maxim L.; Nober, William; Meyerson, Lindsay (2020-09-25)
Does health insurance improve health? This question, while apparently a tautology, has been the subject of considerable economic debate. In light of the COVID-19 pandemic, it has acquired a greater urgency as the lack of universal health insurance has been cited as a cause of the profound racial gap in coronavirus cases, and as a cause of U.S. difficulties in managing the pandemic more generally. However, estimating the effect of health insurance is difficult because it is (generally) not assigned at random. In this post, we approach this question in a novel way by exploiting a natural ...
Liberty Street Economics , Paper 20200925

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