IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/33918.html
   My bibliography  Save this paper

Who Benefits from Paid Family Leave? The Impact on Informal and Formal Care for Middle-Aged and Older Adults with Disabilities

Author

Listed:
  • Yuting Qian
  • Xi Chen

Abstract

This paper analyzes the impact of paid family leave (PFL) policies on informal and formal care for middle-aged and older adults with disabilities in the U.S., and how the heterogeneous benefits accrue to different families. We use data from the 1998-2018 Health and Retirement Study (HRS) and leverage the PFL programs implemented in California (2004), New Jersey (2009), and New York (2018) in a difference-in-differences (DiD) design. We deploy both the conventional two-way fixed effects (TWFE) model and an adapted DiD estimator developed by Sun and Abraham for staggered rollout designs. We find that PFL access is associated with a 5.7 percentage point increase in the likelihood that individuals with disabilities receive informal care from their children. We also show that PFL access significantly increases the use of home care services and nursing home care. These effects are primarily concentrated among individuals with disabilities who have both a spouse and children, and are almost non-existent among those who have only children and no spouse. Our findings demonstrate that PFL policies improve care access and help address unmet care needs for middle-aged and older adults with disabilities, but their impact remains limited for certain vulnerable subgroups, particularly those with only children.

Suggested Citation

  • Yuting Qian & Xi Chen, 2025. "Who Benefits from Paid Family Leave? The Impact on Informal and Formal Care for Middle-Aged and Older Adults with Disabilities," NBER Working Papers 33918, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:33918
    Note: AG EH LS PE
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w33918.pdf
    Download Restriction: Access to the full text is generally limited to series subscribers, however if the top level domain of the client browser is in a developing country or transition economy free access is provided. More information about subscriptions and free access is available at http://www.nber.org/wwphelp.html. Free access is also available to older working papers.
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Norma B. Coe & Jing Guo & R. Tamara Konetzka & Courtney Harold Van Houtven, 2019. "What is the marginal benefit of payment‐induced family care? Impact on Medicaid spending and health of care recipients," Health Economics, John Wiley & Sons, Ltd., vol. 28(5), pages 678-692, May.
    2. Charles L. Baum & Christopher J. Ruhm, 2016. "The Effects of Paid Family Leave in California on Labor Market Outcomes," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 35(2), pages 333-356, April.
    3. Christopher J. Ruhm, 1997. "Policy Watch: The Family and Medical Leave Act," Journal of Economic Perspectives, American Economic Association, vol. 11(3), pages 175-186, Summer.
    4. Tirthatanmoy Das & Solomon W. Polachek, 2015. "Unanticipated Effects Of California'S Paid Family Leave Program," Contemporary Economic Policy, Western Economic Association International, vol. 33(4), pages 619-635, October.
    5. Courtney Coile & Maya Rossin-Slater & Amanda Su, 2022. "The Impact of Paid Family Leave on Families with Health Shocks," NBER Working Papers 30739, National Bureau of Economic Research, Inc.
    6. Seth M. Freedman & Alex Hollingsworth & Kosali I. Simon & Coady Wing & Madeline Yozwiak, 2023. "Designing Difference in Difference Studies With Staggered Treatment Adoption: Key Concepts and Practical Guidelines," NBER Working Papers 31842, National Bureau of Economic Research, Inc.
    7. Anand, Priyanka & Dague, Laura & Wagner, Kathryn L., 2022. "The role of paid family leave in labor supply responses to a spouse's disability or health shock," Journal of Health Economics, Elsevier, vol. 83(C).
    8. Tanya S. Byker, 2016. "Paid Parental Leave Laws in the United States: Does Short-Duration Leave Affect Women's Labor-Force Attachment?," American Economic Review, American Economic Association, vol. 106(5), pages 242-246, May.
    9. Van Houtven, Courtney Harold & Norton, Edward C., 2004. "Informal care and health care use of older adults," Journal of Health Economics, Elsevier, vol. 23(6), pages 1159-1180, November.
    10. Charles, Kerwin Kofi & Sevak, Purvi, 2005. "Can family caregiving substitute for nursing home care?," Journal of Health Economics, Elsevier, vol. 24(6), pages 1174-1190, November.
    11. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    12. Bonsang, Eric, 2009. "Does informal care from children to their elderly parents substitute for formal care in Europe?," Journal of Health Economics, Elsevier, vol. 28(1), pages 143-154, January.
    13. Saad-Lessler, Joelle, 2020. "How does paid family leave affect unpaid care providers?," The Journal of the Economics of Ageing, Elsevier, vol. 17(C).
    14. Rafael Lalive & Josef Zweimüller, 2009. "How Does Parental Leave Affect Fertility and Return to Work? Evidence from Two Natural Experiments," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 124(3), pages 1363-1402.
    15. Kanika Arora & Douglas A. Wolf, 2018. "Does Paid Family Leave Reduce Nursing Home Use? The California Experience," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 37(1), pages 38-62, January.
    16. Braga, Breno & Butrica, Barbara A. & Mudrazija, Stipica & Peters, H.E., 2022. "Impacts of State Paid Family Leave Policies for Older Workers with Spouses or Parents in Poor Health," IZA Discussion Papers 15007, Institute of Labor Economics (IZA).
    Full references (including those not matched with items on IDEAS)

    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. Anand, Priyanka & Dague, Laura & Wagner, Kathryn L., 2022. "The role of paid family leave in labor supply responses to a spouse's disability or health shock," Journal of Health Economics, Elsevier, vol. 83(C).
    2. Courtney Coile & Maya Rossin-Slater & Amanda Su, 2022. "The Impact of Paid Family Leave on Families with Health Shocks," NBER Working Papers 30739, National Bureau of Economic Research, Inc.
    3. Jones, Kelly & Wilcher, Britni, 2024. "Reducing maternal labor market detachment: A role for paid family leave," Labour Economics, Elsevier, vol. 87(C).
    4. Eleanor Golightly & Pamela Meyerhofer, 2022. "Does Paid Family Leave Cause Mothers to Have More Children? Evidence from California," Journal of Labor Research, Springer, vol. 43(2), pages 203-238, June.
    5. Timpe, Brenden, 2024. "The labor market impacts of America’s first paid maternity leave policy," Journal of Public Economics, Elsevier, vol. 231(C).
    6. Chia Jung Chang, 2021. "Is the Road to Unemployment Paved with Good Intentions? Labor Market Outcomes of Young Women," Journal of Labor Research, Springer, vol. 42(2), pages 244-302, June.
    7. Maya Rossin-Slater, 2017. "Maternity and Family Leave Policy," NBER Working Papers 23069, National Bureau of Economic Research, Inc.
    8. Minamo MIKOSHIBA, 2025. "Universal Insurance with In-kind Transfers: The welfare effects of long-term care insurance in Japan," Discussion papers 25030, Research Institute of Economy, Trade and Industry (RIETI).
    9. Sarah H. Bana & Kelly Bedard & Maya Rossin‐Slater, 2020. "The Impacts of Paid Family Leave Benefits: Regression Kink Evidence from California Administrative Data," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(4), pages 888-929, September.
    10. Rossin-Slater, Maya, 2017. "Maternity and Family Leave Policy," IZA Discussion Papers 10500, Institute of Labor Economics (IZA).
    11. Jiyoon Kim & Otto Lenhart, 2024. "Paid family leave and the fight against hunger: Evidence from New York," Health Economics, John Wiley & Sons, Ltd., vol. 33(7), pages 1503-1527, July.
    12. Coe, Norma B. & Goda, Gopi Shah & Van Houtven, Courtney Harold, 2023. "Family spillovers and long-term care insurance," Journal of Health Economics, Elsevier, vol. 90(C).
    13. Bergeot, Julien & Tenand, Marianne, 2023. "Does informal care delay nursing home entry? Evidence from Dutch linked survey and administrative data," Journal of Health Economics, Elsevier, vol. 92(C).
    14. Wendy A. Stock & Myron Inglis, 2021. "The longer‐term labor market impacts of paid parental leave," Growth and Change, Wiley Blackwell, vol. 52(2), pages 838-884, June.
    15. Braga, Breno & Butrica, Barbara A. & Mudrazija, Stipica & Peters, H.E., 2022. "Impacts of State Paid Family Leave Policies for Older Workers with Spouses or Parents in Poor Health," IZA Discussion Papers 15007, Institute of Labor Economics (IZA).
    16. M. Martin Boyer & Philippe De Donder & Claude Denys Fluet & Marie-Louise Leroux & Pierre-Carl Michaud, 2018. "A Canadian Parlor Room-Type Approach to the Long-Term Care Insurance Puzzle," CIRANO Working Papers 2018s-13, CIRANO.
    17. Costa-Font, Joan & Jiménez-Martín, Sergi & Vilaplana-Prieto, Cristina, 2022. "Do Public Caregiving Subsidies and Supports affect the Provision of Care and Transfers?," Journal of Health Economics, Elsevier, vol. 84(C).
    18. Lee, M-J & Kim, Y-S, 2011. "Effects of Informal Family Care on Formal Health Care: Zero-Inflated Endogenous Count for Censored Response," Health, Econometrics and Data Group (HEDG) Working Papers 11/10, HEDG, c/o Department of Economics, University of York.
    19. Mommaerts, Corina & Truskinovsky, Yulya, 2020. "The cyclicality of informal care," Journal of Health Economics, Elsevier, vol. 71(C).
    20. Yoko Niimi, 2016. "The “Costs” of informal care: an analysis of the impact of elderly care on caregivers’ subjective well-being in Japan," Review of Economics of the Household, Springer, vol. 14(4), pages 779-810, December.

    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination
    • J18 - Labor and Demographic Economics - - Demographic Economics - - - Public Policy

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:nbr:nberwo:33918. 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: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.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.