We study the labor market and mental health impacts of debt relief among financially vulnerable individuals. We exploit a cutoff rule used by a Dutch welfare office to determine eligibility to debt relief of welfare debts. We use this cutoff as an instrument in both a fuzzy regression...

Purpose - Health shocks are among the factors that have impeded households from experiencing better welfare. To mitigate the consequences of these shocks, individuals have sought to enrol in a formal insurance scheme or borrow from banks. This study estimates the effects of health shocks on...

One challenge presented by population aging is how to adjust public support for social care in a way that achieves desired quality of life outcomes without compromising budget sustainability. This study uses best-practice methods of economic analysis to explore projections for care and related...

Upcoding in Medicare has been a topic of interest to economists and policy makers for nearly 40 years. While upcoding is generally understood as "billing for services at higher level of complexity than the service actually pro- vided or documented," it has a wide range of definitions within the...

Take-up of social benefits is a central issue in poverty alleviation and fiscal evaluations of policy reforms. However, it is difficult to find exogenous variation in the benefit level, and little is therefore known about take-up responses to basic financial incentives. We exploit large and...

Use of public assistance by noncitizens is controversial. Before 2018, institutionalization and receipt of cash benefits were considered as evidence of whether immigrants were likely to become a "public charge" and, therefore, ineligible for citizenship. But a new rule-proposed in 2018 and...

Integration agreements (IA) outline the efforts the jobseeker should undertake to find employment and specify the services that the caseworker would provide to assist them in their job search. The agreements include a declaration of legal consequences, and punitive benefit sanctions could be...

We examine whether increases in Medicaid coverage among teens reduced suicide risk. Youth are at elevated risk for depression but receive the least care. We exploit state-level variation in Medicaid coverage controlling for crowd-out to identify effects on risk for suicide. We build an...

While a large literature examines the immediate and long-run effects of public health insurance, much less is known about the impacts of total program exposure on child developmental outcomes. This paper uses an instrumental variable strategy to estimate the effect of cumulative eligibility gain...

Supplemental Nutrition Assistance Program (SNAP) is the backbone of the U.S. safety net. We provide the most comprehensive and generalizable evaluation of the labor supply effects of access to modern SNAP to date. To do so we use new, rich administrative data and an examiner design based on...

Background The Affordable Care Act (ACA), enacted in 2010, aimed to improve healthcare coverage for American citizens. This study investigates the impact of Medicaid expansion (ME) under the ACA on the racial and ethnic com- position of nursing home admissions in the U.S., focusing on whether ME...

We study the labor market and mental health impacts of debt relief among financially vulnerable individuals. We exploit a cutoff rule used by a Dutch welfare office to determine eligibility to debt relief of welfare debts. We use this cutoff as an instrument in both a fuzzy regression...

Insurers subcontract with pharmacy benefit managers (PBMs) to administer drug insurance. PBMs typically profit from the difference between a fixed amount and the reimbursement paid to pharmacies (i.e., "spread pricing"). Some states require insurers and PBMs to use cost-plus contracts, in which...

Due to population aging, the number of people needing long-term care is growing, and an increasing number of people are receiving this care at home, rather than in nursing homes. This trend has been driven in part by Medicaid, which has significantly increased public financing of formal home...

To curb federal Medicaid costs, recent policy proposals suggest capitation financing, under which program costs are fixed per beneficiary. This study examines to what extent less generous capitated federal subsidies would cause states to decrease Medicaid enrollment. To answer this question, we...

Most of the 600,000 adults returning to the community from state and federal prisons annually in the U.S. carry substantial debt, have low income and low education, and limited formal employment prior to entering prison. Upon reentry, they face financial hardship, high rates of morbidity and...

Welfare caseloads in North America halved following reforms in the 1990s and 2000s. We study how this shift affected families by linking Canadian welfare records to tax returns, medical spending, educational attainment, and crime data. We find substantial and heterogeneous employment responses...

We study the intergenerational transmission of welfare benefit receipt in Germany. We first describe the correlation between welfare receipt experienced in the parental household and subsequent own welfare receipt of young adults. In a second step, we investigate whether the observed...

Indonesia has lowered the total poverty rate by less than 10%. Earlier poverty measurements in Indonesia suggest that transient poverty is more prevalent. We argue that, when employing the Equally Distributed Equivalent (EDE) approach and disaggregated poverty lines, chronic poverty is more...

Provider payments are the key determinant of insurance generosity within many health insurance programs covering low-income populations. This paper analyzes the effects of a large, federally-mandated provider payment increase for primary care services provided to low-income elderly and disabled...

We study the intergenerational transmission of welfare benefit receipt in Germany. We first describe the correlation between welfare receipt experienced in the parental household and subsequent own welfare receipt of young adults. In a second step, we investigate whether the observed...

We estimate the causal impact of access to means-tested public health insurance coverage (Medicaid) on health outcomes and recidivism for those recently released from incarceration. To do so, we leverage a policy change in South Carolina that allowed simplified Medicaid re-enrollment for...

We study the intergenerational transmission of welfare benefit receipt in Germany. We first describe the correlation between welfare receipt experienced in the parental household and subsequent own welfare receipt of young adults. In a second step, we investigate whether the observed...

We study the intergenerational transmission of welfare benefit receipt in Germany. We first describe the correlation between welfare receipt experienced in the parental household and subsequent own welfare receipt of young adults. In a second step, we investigate whether the observed...

How do administrative burdens influence enrollment in different welfare programs? Who is screened out at a given stage? This paper studies the impacts of increased administrative burdens associated with the automation of welfare caseworker assistance, leveraging a unique natural experiment in...

High administrative costs in U.S. health care have provoked concern among policymakers over potential waste, but many of these costs are generated by managed care policies that trade off bureaucratic costs against reductions in moral hazard. We study this trade-off for prior authorization...

Financial scarcity is a fundamental condition for recipients of social welfare. But how does scarcity affect their ability to improve their prospects? In a field experiment using Danish unemployed social assistance recipients (N = 2,637), we test the impact of scarcity by randomly assigning...

This paper assesses the impact of an information dissemination intervention on the local-level implementation of the rural public works program in India. One key feature of the intervention is to provide information to workers once their wages get credited into their accounts. Using...

Recipients of government transfers are economically disadvantaged, yet little is known about how their circumstances evolve leading up to program receipt. Using twenty-five years of survey data as well as administrative health records, we establish three new stylized facts around enrollment in...