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Health insurance coverage and the macroeconomy

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  • Cawley, John
  • Simon, Kosali I.

Abstract

The primary objective of this paper is to improve our understanding of the historic relationship between state and national macroeconomic climate and the health insurance coverage of Americans. The secondary objective of this paper is to use the historic findings to estimate how the number of uninsured Americans changed during the 2001 recession, and to estimate whether to date enough people have gained health insurance during the current recovery to offset the losses during the recession. We conclude that the macroeconomy (measured by state unemployment rate and real gross state product) is correlated with the probability of men's health insurance coverage and that this correlation is only partly explained by changes in men's employment status. Counter-cyclical health insurance programs such as Medicaid and the State Children's Health Insurance Program seem to ensure that the health insurance coverage of women and children is insulated from macroeconomic changes. We estimate that 851,000 Americans, the vast majority of whom were adult men, lost health insurance due to macroeconomic conditions alone during the 2001 recession.
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  • Cawley, John & Simon, Kosali I., 2005. "Health insurance coverage and the macroeconomy," Journal of Health Economics, Elsevier, vol. 24(2), pages 299-315, March.
    • Handle: RePEc:eee:jhecon:v:24:y:2005:i:2:p:299-315
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    Cited by:

    1. Joan Costa-Font & Martin Karlsson & Henning Øien, 2015. "Informal Care and the Great Recession," CINCH Working Paper Series 1502, Universitaet Duisburg-Essen, Competent in Competition and Health, revised Feb 2015.
    2. McInerney, Melissa & Mellor, Jennifer M., 2012. "Recessions and seniors’ health, health behaviors, and healthcare use: Analysis of the Medicare Current Beneficiary Survey," Journal of Health Economics, Elsevier, vol. 31(5), pages 744-751.
    3. Joan Costa‐Font & Martin Karlsson & Henning Øien, 2016. "Careful in the Crisis? Determinants of Older People's Informal Care Receipt in Crisis‐Struck European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 25(S2), pages 25-42, November.
    4. Maclean, Johanna Catherine & Tello-Trillo, Sebastian & Webber, Douglas, 2023. "Losing insurance and psychiatric hospitalizations," Journal of Economic Behavior & Organization, Elsevier, vol. 205(C), pages 508-527.
    5. John Cawley & Asako S. Moriya & Kosali Simon, 2015. "The Impact of the Macroeconomy on Health Insurance Coverage: Evidence from the Great Recession," Health Economics, John Wiley & Sons, Ltd., vol. 24(2), pages 206-223, February.
    6. Maclean, J. Catherine & Tello-Trillo, Sebastian & Webber, Douglas A., 2019. "Losing Insurance and Behavioral Health Hospitalizations: Evidence from a Large-Scale Medicaid Disenrollment," IZA Discussion Papers 12463, Institute of Labor Economics (IZA).
    7. He, Daifeng & McInerney, Melissa & Mellor, Jennifer, 2015. "Physician responses to rising local unemployment rates: Healthcare provision to Medicare and privately insured patients," Journal of Health Economics, Elsevier, vol. 40(C), pages 97-108.
    8. Alice Chen & Anthony T. Lo Sasso & Michael R. Richards, 2018. "Supply‐side effects from public insurance expansions: Evidence from physician labor markets," Health Economics, John Wiley & Sons, Ltd., vol. 27(4), pages 690-708, April.
    9. Nyman, John A. & Koc, Cagatay & Dowd, Bryan E. & McCreedy, Ellen & Trenz, Helen Markelova, 2018. "Decomposition of moral hazard," Journal of Health Economics, Elsevier, vol. 57(C), pages 168-178.
    10. Lawrence Pellegrini & Rosa Rodriguez-Monguio & Jing Qian, 2014. "The US healthcare workforce and the labor market effect on healthcare spending and health outcomes," International Journal of Health Economics and Management, Springer, vol. 14(2), pages 127-141, June.
    11. Jean M. Abraham & Anne B. Royalty & Coleman Drake, 2019. "The impact of Medicaid expansion on employer provision of health insurance," International Journal of Health Economics and Management, Springer, vol. 19(3), pages 317-340, December.
    12. Daysal, N. Meltem, 2012. "Does uninsurance affect the health outcomes of the insured? Evidence from heart attack patients in California," Journal of Health Economics, Elsevier, vol. 31(4), pages 545-563.
    13. Stephen Barnes & Dek Terrell, 2009. "The Impact of the Labor Market on Health Insurance," Journal of Labor Research, Springer, vol. 30(4), pages 328-339, December.
    14. Martha A. Starr, 2011. "Recession and the Social Economy," Perspectives from Social Economics, in: Martha A. Starr (ed.), Consequences of Economic Downturn, chapter 0, pages 189-214, Palgrave Macmillan.
    15. H. Elizabeth Peters & Kosali Simon & Jamie Rubenstein Taber, 2014. "Marital Disruption and Health Insurance," NBER Working Papers 20233, National Bureau of Economic Research, Inc.
    16. Johanna Maclean, 2014. "Does leaving school in an economic downturn impact access to employer-sponsored health insurance?," IZA Journal of Labor Policy, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 3(1), pages 1-27, December.
    17. Towne, Samuel D. & Probst, Janice C. & Hardin, James W. & Bell, Bethany A. & Glover, Saundra, 2017. "Health & access to care among working-age lower income adults in the Great Recession: Disparities across race and ethnicity and geospatial factors," Social Science & Medicine, Elsevier, vol. 182(C), pages 30-44.
    18. H. Peters & Kosali Simon & Jamie Taber, 2014. "Marital Disruption and Health Insurance," Demography, Springer;Population Association of America (PAA), vol. 51(4), pages 1397-1421, August.
    19. Andrea Menclova, 2013. "The Effects of Unemployment on Prenatal Care Use and Infant Health," Journal of Family and Economic Issues, Springer, vol. 34(4), pages 400-420, December.
    20. Carpenter, Christopher S. & McClellan, Chandler B. & Rees, Daniel I., 2017. "Economic conditions, illicit drug use, and substance use disorders in the United States," Journal of Health Economics, Elsevier, vol. 52(C), pages 63-73.
    21. Andrea Kutinova, 2006. "The Effects of Unemployment on Childbearing," Working Papers in Economics 06/12, University of Canterbury, Department of Economics and Finance.
    22. Jonathan H. Cantor & Brady P. Horn & Johanna Catherine Maclean, 2013. "Recessions and Admissions to Substance Abuse Treatment," NBER Working Papers 19115, National Bureau of Economic Research, Inc.
    23. Johanna Catherine Maclean & Jonathan H. Cantor & Rosalie Liccardo Pacula, 2015. "Economic downturns and substance abuse treatment: Evidence from admissions data," DETU Working Papers 1504, Department of Economics, Temple University.
    24. Alice Chen & Anthony Lo Sasso & Michael R. Richards, 2018. "Graduating into a downturn: Are physicians recession proof?," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 223-235, January.
    25. Koh, Kanghyock, 2018. "The Great Recession and Workers’ Health Benefits," Journal of Health Economics, Elsevier, vol. 58(C), pages 18-28.

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    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • J3 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs

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