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Health Insurance Coverage and the Macroeconomy

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  • John Cawley
  • Kosali I. Simon

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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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 10092.

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Date of creation: Nov 2003
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Publication status: published as Cawley, John, and Kosali I. Simon. "Health Insurance Coverage and the Macroeconomy." Journal of Health Economics, March 2005, 24(2): 299-315.
Handle: RePEc:nbr:nberwo:10092

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  1. Christopher J. Ruhm, 1996. "Are Recessions Good For Your Health?," NBER Working Papers 5570, National Bureau of Economic Research, Inc.
  2. Currie, Janet & Gruber, Jonathan, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, MIT Press, vol. 111(2), pages 431-66, May.
  3. Christopher Ruhm, 1994. "Economic Conditions and Alcohol Problems," NBER Working Papers 4914, National Bureau of Economic Research, Inc.
  4. David M. Cutler, 2002. "Employee Costs and the Decline in Health Insurance Coverage," NBER Working Papers 9036, National Bureau of Economic Research, Inc.
  5. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2002. "How Much Should We Trust Differences-in-Differences Estimates?," NBER Working Papers 8841, National Bureau of Economic Research, Inc.
  6. Roger Feldman & Bryan Dowd & Scott Leitz & Lynn A. Blewett, 1997. "The Effect of Premiums on the Small Firm's Decision to Offer Health Insurance," Journal of Human Resources, University of Wisconsin Press, vol. 32(4), pages 635-658.
  7. Ruhm, Christopher J., 2003. "Good times make you sick," Journal of Health Economics, Elsevier, vol. 22(4), pages 637-658, July.
  8. Sherry Glied & Kathrine Jack, 2003. "Macroeconomic Conditions, Health Care Costs, and the Distribution of Health Insurance," NBER Working Papers 10029, National Bureau of Economic Research, Inc.
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Cited by:
  1. H. Elizabeth Peters & Kosali Simon & Jamie Rubenstein Taber, 2014. "Marital Disruption and Health Insurance," NBER Working Papers 20233, National Bureau of Economic Research, Inc.
  2. Andrea Kutinova, 2006. "The Effects of Unemployment on Childbearing," Working Papers in Economics 06/12, University of Canterbury, Department of Economics and Finance.
  3. 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.
  4. Daysal, N. Meltem, 2012. "Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California," Discussion Paper 2012-027, Tilburg University, Center for Economic Research.
  5. 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 Care Finance and Economics, Springer, vol. 14(2), pages 127-141, June.
  6. Martha A. Starr, 2010. "Recession and the Social Economy," Working Papers 2010-08, American University, Department of Economics.
  7. Johanna Catherine Maclean & Jonathan H. Cantor & Rosalie Liccardo Pacula, 2013. "Economic Downturns and Substance Abuse Treatment: Evidence from Admissions Data," NBER Working Papers 19115, National Bureau of Economic Research, Inc.
  8. 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.
  9. 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.

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