IDEAS home Printed from https://ideas.repec.org/a/wly/iecrev/v59y2018i3p1283-1313.html
   My bibliography  Save this article

Medicaid And The Labor Supply Of Single Mothers: Implications For Health Care Reform

Author

Listed:
  • R. Vincent Pohl

Abstract

The Medicaid expansions and health insurance subsidies of the Affordable Care Act (ACA) change work incentives for single mothers. To evaluate the employment effects of these policies ex ante, I estimate a model of labor supply and health insurance choice exploiting variation in pre‐ACA Medicaid policies. Simulations show that single mothers increase their labor supply at the extensive and intensive margin by 12% and 7%, respectively, uninsurance rates decline by up to 40%, and an average family's welfare improves by 1,600 dollars per year. Health insurance subsidies and not Medicaid expansions mostly drive these effects.

Suggested Citation

  • R. Vincent Pohl, 2018. "Medicaid And The Labor Supply Of Single Mothers: Implications For Health Care Reform," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 59(3), pages 1283-1313, August.
    • Handle: RePEc:wly:iecrev:v:59:y:2018:i:3:p:1283-1313
    DOI: 10.1111/iere.12304
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/iere.12304
    Download Restriction: no
    File URL: https://libkey.io/10.1111/iere.12304?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. John C. Ham & Lara D. Shore-Sheppard, 2005. "Did Expanding Medicaid Affect Welfare Participation?," ILR Review, Cornell University, ILR School, vol. 58(3), pages 452-470, April.
    2. Congressional Budget Office, 2014. "Updated Budget Projections: 2014 to 2024," Reports 45229, Congressional Budget Office.
    3. Shore-Sheppard Lara D., 2008. "Stemming the Tide? The Effect of Expanding Medicaid Eligibility On Health Insurance Coverage," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 8(2), pages 1-35, July.
    4. Naoki Aizawa & Hanming Fang, 2020. "Equilibrium Labor Market Search and Health Insurance Reform," Journal of Political Economy, University of Chicago Press, vol. 128(11), pages 4258-4336.
    5. Jonathan Gruber & Brigitte C. Madrian, 2002. "Health Insurance, Labor Supply, and Job Mobility: A Critical Review of the Literature," JCPR Working Papers 255, Northwestern University/University of Chicago Joint Center for Poverty Research.
    6. Amy Finkelstein & Erzo F. P. Luttmer & Matthew J. Notowidigdo, 2013. "What Good Is Wealth Without Health? The Effect Of Health On The Marginal Utility Of Consumption," Journal of the European Economic Association, European Economic Association, vol. 11, pages 221-258, January.
    7. Fraker, Thomas & Moffitt, Robert, 1988. "The effect of food stamps on labor supply : A bivariate selection model," Journal of Public Economics, Elsevier, vol. 35(1), pages 25-56, February.
    8. Mullahy, John, 1998. "Much ado about two: reconsidering retransformation and the two-part model in health econometrics," Journal of Health Economics, Elsevier, vol. 17(3), pages 247-281, June.
    9. Keane, Michael & Moffitt, Robert, 1998. "A Structural Model of Multiple Welfare Program Participation and Labor Supply," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 39(3), pages 553-589, August.
    10. Strumpf, Erin, 2011. "Medicaid's effect on single women's labor supply: Evidence from the introduction of Medicaid," Journal of Health Economics, Elsevier, vol. 30(3), pages 531-548, May.
    11. John Mullahy, 1998. "Much Ado About Two: Reconsidering Retransformation and the Two-Part Model in Health Economics," NBER Technical Working Papers 0228, National Bureau of Economic Research, Inc.
    12. Orazio P. Attanasio & Costas Meghir & Ana Santiago, 2012. "Education Choices in Mexico: Using a Structural Model and a Randomized Experiment to Evaluate PROGRESA," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 79(1), pages 37-66.
    13. Kolstad, Jonathan T. & Kowalski, Amanda E., 2016. "Mandate-based health reform and the labor market: Evidence from the Massachusetts reform," Journal of Health Economics, Elsevier, vol. 47(C), pages 81-106.
    14. Congressional Budget Office, 2014. "The Budget and Economic Outlook: 2014 to 2024," Reports 45010, Congressional Budget Office.
    15. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 391-430.
    16. Iourii Manovskii & Bjoern Bruegemann, 2009. "Fragility: A Quantitative Analysis of the US Health Insurance System," 2009 Meeting Papers 1246, Society for Economic Dynamics.
    17. Jonathan T. Kolstad & Amanda E. Kowalski, 2012. "Mandate-Based Health Reform and the Labor Market:� Evidence from the Massachusetts Reform," Cowles Foundation Discussion Papers 1855, Cowles Foundation for Research in Economics, Yale University.
    18. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-1296, December.
    19. David Card & Andrew K.G. Hildreth & Lara D. Shore-Sheppard, 2004. "The Measurement of Medicaid Coverage in the SIPP: Evidence From a Comparison of Matched Records," Journal of Business & Economic Statistics, American Statistical Association, vol. 22, pages 410-420, October.
    20. Christopher Ferrall, 2012. "Explaining and Forecasting Results of the Self-sufficiency Project," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 79(4), pages 1495-1526.
    21. Congressional Budget Office, 2014. "An Update to the Budget and Economic Outlook: 2014 to 2024," Reports 45653, Congressional Budget Office.
    22. Zweifel, Peter & Manning, Willard G., 2000. "Moral hazard and consumer incentives in health care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 8, pages 409-459, Elsevier.
    23. Thomas DeLeire & Leonard Lopoo & Kosali Simon, 2011. "Medicaid Expansions and Fertility in the United States," Demography, Springer;Population Association of America (PAA), vol. 48(2), pages 725-747, May.
    24. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, Oxford University Press, vol. 127(3), pages 1057-1106.
    25. Moffitt, Robert & Wolfe, Barbara L, 1992. "The Effect of the Medicaid Program on Welfare Participation and Labor Supply," The Review of Economics and Statistics, MIT Press, vol. 74(4), pages 615-626, November.
    26. A. Zabalza & C. Pissarides & M. Barton, 1980. "Social Security and the Choice between Full-time Work, Part-time Work and Retirement," NBER Chapters, in: Econometric Studies in Public Finance, pages 245-276, National Bureau of Economic Research, Inc.
    27. Rebecca M. Blank, 1989. "The Effect of Medical Need and Medicaid on AFDC Participation," Journal of Human Resources, University of Wisconsin Press, vol. 24(1), pages 54-87.
    28. Michael P. Keane, 2011. "Labor Supply and Taxes: A Survey," Journal of Economic Literature, American Economic Association, vol. 49(4), pages 961-1075, December.
    29. Congressional Budget Office, 2014. "The Budget and Economic Outlook: 2014 to 2024," Reports 45010, Congressional Budget Office.
    30. Gordon B. Dahl, 2002. "Mobility and the Return to Education: Testing a Roy Model with Multiple Markets," Econometrica, Econometric Society, vol. 70(6), pages 2367-2420, November.
    31. Anne E. Winkler, 1991. "The Incentive Effects of Medicaid on Women's Labor Supply," Journal of Human Resources, University of Wisconsin Press, vol. 26(2), pages 308-337.
    32. Congressional Budget Office, 2014. "An Update to the Budget and Economic Outlook: 2014 to 2024," Reports 45653, Congressional Budget Office.
    33. Kenneth I. Wolpin & Petra E. Todd, 2006. "Assessing the Impact of a School Subsidy Program in Mexico: Using a Social Experiment to Validate a Dynamic Behavioral Model of Child Schooling and Fertility," American Economic Review, American Economic Association, vol. 96(5), pages 1384-1417, December.
    34. Wolpin, Kenneth I., 2013. "The Limits of Inference without Theory," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262019086, December.
    35. Kennan, John & Walker, James R., 2010. "Wages, welfare benefits and migration," Journal of Econometrics, Elsevier, vol. 156(1), pages 229-238, May.
    36. Congressional Budget Office, 2014. "An Update to the Budget and Economic Outlook: 2014 to 2024," Reports 45653, Congressional Budget Office.
    37. Thomas C. Buchmueller & Robert G. Valletta, 1999. "The Effect of Health Insurance on Married Female Labor Supply," Journal of Human Resources, University of Wisconsin Press, vol. 34(1), pages 42-70.
    38. Congressional Budget Office, 2014. "The Budget and Economic Outlook: 2014 to 2024," Reports 45010, Congressional Budget Office.
    39. Sandra Decker & Frederic Selck, 2012. "The effect of the original introduction of Medicaid on welfare participation and female labor supply," Review of Economics of the Household, Springer, vol. 10(4), pages 541-556, December.
    40. Hamersma, Sarah & Kim, Matthew, 2009. "The effect of parental Medicaid expansions on job mobility," Journal of Health Economics, Elsevier, vol. 28(4), pages 761-770, July.
    41. Hamersma Sarah, 2013. "The Effects of Medicaid Earnings Limits on Earnings Growth among Poor Workers," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 13(2), pages 887-919, August.
    42. Congressional Budget Office, 2014. "The Budget and Economic Outlook: 2014 to 2024," Reports 45010, Congressional Budget Office.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Bradley Heim & Ithai Lurie & Kosali Simon, 2018. "Did the Affordable Care Act Young Adult Provision Affect Labor Market Outcomes? Analysis Using Tax Data," ILR Review, Cornell University, ILR School, vol. 71(5), pages 1154-1178, October.
    2. Thomas C. Buchmueller & Helen Levy & Robert G. Valletta, 2021. "Medicaid Expansion and the Unemployed," Journal of Labor Economics, University of Chicago Press, vol. 39(S2), pages 575-617.
    3. Jonathan T. Kolstad & Amanda E. Kowalski, 2012. "Mandate-Based Health Reform and the Labor Market:� Evidence from the Massachusetts Reform," Cowles Foundation Discussion Papers 1855, Cowles Foundation for Research in Economics, Yale University.
    4. Kathryn L. Clark & R. Vincent Pohl & Ryan C. Thomas, 2020. "Minimum Wages And Healthy Diet," Contemporary Economic Policy, Western Economic Association International, vol. 38(3), pages 546-560, July.
    5. Étienne Gaudette & Gwyn C. Pauley & Julie Zissimopoulos, 2016. "Long-term Individual and Population Consequences of Early-life Access to Health Insurance," Working Papers wp355, University of Michigan, Michigan Retirement Research Center.
    6. Kolstad, Jonathan T. & Kowalski, Amanda E., 2016. "Mandate-based health reform and the labor market: Evidence from the Massachusetts reform," Journal of Health Economics, Elsevier, vol. 47(C), pages 81-106.
    7. Chao Fu & Naoki Aizawa, 2017. "Local Market Equilibrium and the Design of Public Health Insurance System," 2017 Meeting Papers 1448, Society for Economic Dynamics.
    8. Bradley Heim & Ithai Lurie & Kosali Simon, 2015. "The Impact of the Affordable Care Act Young Adult Provision on Labor Market Outcomes: Evidence from Tax Data," Tax Policy and the Economy, University of Chicago Press, vol. 29(1), pages 133-157.
    9. Svetlana Pashchenko & Ponpoje Porapakkarm, 2013. "Quantitative Analysis of Health Insurance Reform: Separating Regulation from Redistribution," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 16(3), pages 383-404, July.
    10. Svetlana Pashchenko & Ponpoje Porapakkarm, 2017. "Work Incentives Of Medicaid Beneficiaries And The Role Of Asset Testing," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 58(4), pages 1117-1154, November.
    11. Naoki Aizawa & Chao Fu, 2020. "Interaction of the Labor Market and the Health Insurance System: Employer-Sponsored, Individual, and Public Insurance," NBER Working Papers 26713, National Bureau of Economic Research, Inc.
    12. Svetlana Pashchenko & Ponpoje Porapakkarm, 2013. "Quantitative Analysis of Health Insurance Reform: Separating Regulation from Redistribution," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 16(3), pages 383-404, July.
    13. Dhaval Dave & Sandra L. Decker & Robert Kaestner & Kosali I. Simon, 2015. "The Effect of Medicaid Expansions in the Late 1980s and Early 1990s on the Labor Supply of Pregnant Women," American Journal of Health Economics, MIT Press, vol. 1(2), pages 165-193, Spring.
    14. Ponpoje (Poe) Porapakkarm & Svetlana Pashchenko, 2013. "Labor Supply Incentives of Medicaid," 2013 Meeting Papers 1082, Society for Economic Dynamics.
    15. Azuara, Oliver & Marinescu, Ioana, 2013. "Informality and the expansion of social protection programs: Evidence from Mexico," Journal of Health Economics, Elsevier, vol. 32(5), pages 938-950.
    16. Chari, A.V. & Valli, Elsa, 2021. "The effect of subsidized childcare on the supply of informal care: Evidence from public kindergarten provision in the US," Journal of Health Economics, Elsevier, vol. 77(C).
    17. repec:mrr:papers:wp341 is not listed on IDEAS
    18. Nga Le Thi Quynh & Groot, Wim & Tomini, Sonila M. & Tomini, Florian, 2017. "Effects of health insurance on labour supply: A systematic review," MERIT Working Papers 2017-017, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).
    19. Ye, Wei & Rodriguez, Javier M., 2021. "Highly vulnerable communities and the Affordable Care Act: Health insurance coverage effects, 2010–2018," Social Science & Medicine, Elsevier, vol. 270(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. repec:mrr:papers:wp341 is not listed on IDEAS
    2. Julie Shi, 2016. "Income Responses to Health Insurance Subsidies: Evidence from Massachusetts," American Journal of Health Economics, MIT Press, vol. 2(1), pages 96-124, January.
    3. Laura J. Owen, 2017. "Part-time Employment and Health Insurance Reform: What Can Massachusetts Tell Us about the Affordable Care Act?," Review of Social Sciences, LAR Center Press, vol. 2(3), pages 1-8, March.
    4. Thomas Buchmueller & John C. Ham & Lara D. Shore-Sheppard, 2015. "The Medicaid Program," NBER Chapters, in: Economics of Means-Tested Transfer Programs in the United States, Volume 1, pages 21-136, National Bureau of Economic Research, Inc.
    5. Boyle, Melissa A. & Lahey, Joanna N., 2016. "Spousal labor market effects from government health insurance: Evidence from a veterans affairs expansion," Journal of Health Economics, Elsevier, vol. 45(C), pages 63-76.
    6. Jane G. Gravelle & Sean Lowry, 2016. "The Affordable Care Act, Labor Supply, and Social Welfare," National Tax Journal, National Tax Association;National Tax Journal, vol. 69(4), pages 863-882, December.
    7. Troy Davig & Michael Redmond, 2014. "Accounting for changes in the U.S. budget deficit," Macro Bulletin, Federal Reserve Bank of Kansas City, pages 1-2, December.
    8. Marianne P. Bitler & Madeline Zavodny, 2014. "Medicaid: A Review of the Literature," NBER Working Papers 20169, National Bureau of Economic Research, Inc.
    9. Bradley Heim & Ithai Lurie & Kosali Simon, 2015. "The Impact of the Affordable Care Act Young Adult Provision on Labor Market Outcomes: Evidence from Tax Data," Tax Policy and the Economy, University of Chicago Press, vol. 29(1), pages 133-157.
    10. Helen Levy & Thomas Buchmueller & Sayeh Nikpay, 2015. "The Effect of Health Reform on Retirement," Working Papers wp329, University of Michigan, Michigan Retirement Research Center.
    11. Anirvan Banerji & Lakshman Achuthan, 2015. "The “Subpar” Recovery: A Long-standing Misunderstanding," Challenge, Taylor & Francis Journals, vol. 58(2), pages 139-148, March.
    12. Sylvain Leduc & Glenn D. Rudebusch, 2014. "Does slower growth imply lower interest rates?," FRBSF Economic Letter, Federal Reserve Bank of San Francisco.
    13. John G. Fernald, 2015. "Productivity and Potential Output before, during, and after the Great Recession," NBER Macroeconomics Annual, University of Chicago Press, vol. 29(1), pages 1-51.
    14. Robert G Murphy & Adam Rohde, 2018. "Rational Bias in Inflation Expectations," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 44(1), pages 153-171, January.
    15. Rodrigo Vergara & Elías Albagli, 2015. "Tasas de Interés de Largo Plazo en Economías Desarrolladas: Tendencias Recientes e Implicancias de Política Monetaria en Chile," Economic Policy Papers Central Bank of Chile 52, Central Bank of Chile.
    16. John Gibson, 2015. "Expanded Social Protection May Do More Harm Than Good: A Pessimistic Review," Asia and the Pacific Policy Studies, Wiley Blackwell, vol. 2(3), pages 652-659, September.
    17. Francesca Castelli & Damien Moore & Gabriel Ehrlich & Jeffrey Perry, 2014. "Modeling the Budgetary Costs of FHA's Single Family Mortgage Insurance: Working Paper 2014-05," Working Papers 45711, Congressional Budget Office.
    18. Georgia Kaplanoglou & Vassilis T. Rapanos & Ioanna C. Bardakas, 2015. "Does Fairness Matter for the Success of Fiscal Consolidation?," Kyklos, Wiley Blackwell, vol. 68(2), pages 197-219, May.
    19. Stephanie Aaronson & Tomaz Cajner & Bruce Fallick & Felix Galbis-Reig & Christopher Smith & William Wascher, 2014. "Labor Force Participation: Recent Developments and Future Prospects," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 45(2 (Fall)), pages 197-275.
    20. Thompson, Owen, 2017. "The long-term health impacts of Medicaid and CHIP," Journal of Health Economics, Elsevier, vol. 51(C), pages 26-40.
    21. William R. Cline, 2014. "Estimates of Fundamental Equilibrium Exchange Rates, November 2014," Policy Briefs PB14-25, Peterson Institute for International Economics.

    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I3 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty
    • J2 - Labor and Demographic Economics - - Demand and Supply of Labor

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:iecrev:v:59:y:2018:i:3:p:1283-1313. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://edirc.repec.org/data/deupaus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.