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Targeting with In-kind Transfers: Evidence from Medicaid Home Care

Author

Listed:
  • Ethan M.J. Lieber
  • Lee M. Lockwood

Abstract

Making a transfer in kind reduces its value to recipients but can improve targeting. We develop an approach to quantifying this tradeoff and apply it to home care. Using randomized experiments by Medicaid, we find that in-kind provision significantly reduces the value of the transfer to recipients while targeting a small fraction of the eligible population that is sicker and has fewer informal caregivers than the average eligible. Under a wide range of assumptions within a standard model, the targeting benefit exceeds the distortion cost. This highlights an important cost of recent reforms toward more flexible benefits.

Suggested Citation

  • Ethan M.J. Lieber & Lee M. Lockwood, 2018. "Targeting with In-kind Transfers: Evidence from Medicaid Home Care," NBER Working Papers 24267, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:24267
    Note: AG EH PE
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    JEL classification:

    • H21 - Public Economics - - Taxation, Subsidies, and Revenue - - - Efficiency; Optimal Taxation
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

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