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The Value of Health Insurance during a Crisis: Effects of Medicaid Implementation on Pandemic Influenza Mortality

Author

Listed:
  • Clay, Karen

    () (Carnegie Mellon University)

  • Lewis, Joshua

    () (University of Montreal)

  • Severnini, Edson R.

    () (Carnegie Mellon University)

  • Wang, Xiao

    (Carnegie Mellon University)

Abstract

This paper studies how better access to public health insurance affects infant mortality during pandemics. Our analysis combines cross-state variation in mandated eligibility for Medicaid with two influenza pandemics — the 1957-58 "Asian Flu" pandemic and the 1968-69 "Hong Kong Flu" — that arrived shortly before and after the program's introduction. Exploiting heterogeneity in the underlying severity of these two shocks across counties, we find no relationship between Medicaid eligibility and pandemic infant mortality during the 1957-58 outbreak. After Medicaid implementation, we find that better access to insurance in high-eligibility states substantially reduced infant mortality during the 1968-69 pandemic. The reductions in pandemic infant mortality are too large to be attributable solely to new Medicaid recipients, suggesting that the expansion in health insurance coverage mitigated disease transmission among the broader population.

Suggested Citation

  • Clay, Karen & Lewis, Joshua & Severnini, Edson R. & Wang, Xiao, 2020. "The Value of Health Insurance during a Crisis: Effects of Medicaid Implementation on Pandemic Influenza Mortality," IZA Discussion Papers 13200, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp13200
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    References listed on IDEAS

    as
    1. Clay, Karen & Lewis, Joshua & Severnini, Edson, 2018. "Pollution, Infectious Disease, and Mortality: Evidence from the 1918 Spanish Influenza Pandemic," The Journal of Economic History, Cambridge University Press, vol. 78(4), pages 1179-1209, December.
    2. Douglas Almond & Joseph J. Doyle & Amanda E. Kowalski & Heidi Williams, 2010. "Estimating Marginal Returns to Medical Care: Evidence from At-risk Newborns," The Quarterly Journal of Economics, Oxford University Press, vol. 125(2), pages 591-634.
    3. Clay, Karen & Lewis, Joshua & Severnini, Edson, 2019. "What explains cross-city variation in mortality during the 1918 influenza pandemic? Evidence from 438 U.S. cities," Economics & Human Biology, Elsevier, vol. 35(C), pages 42-50.
    4. Jens Ludwig & Douglas L. Miller, 2007. "Does Head Start Improve Children's Life Chances? Evidence from a Regression Discontinuity Design," The Quarterly Journal of Economics, Oxford University Press, vol. 122(1), pages 159-208.
    5. Richard E. Nelson, 2010. "Testing the Fetal Origins Hypothesis in a developing country: evidence from the 1918 Influenza Pandemic," Health Economics, John Wiley & Sons, Ltd., vol. 19(10), pages 1181-1192, October.
    6. Elaine Kelly, 2011. "The Scourge of Asian Flu: In utero Exposure to Pandemic Influenza and the Development of a Cohort of British Children," Journal of Human Resources, University of Wisconsin Press, vol. 46(4), pages 669-694.
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    More about this item

    Keywords

    public health insurance; medicaid; influenza pandemics;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • N32 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - U.S.; Canada: 1913-
    • N52 - Economic History - - Agriculture, Natural Resources, Environment and Extractive Industries - - - U.S.; Canada: 1913-

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