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...

While it is well established that welfare bureaucrats hold some discretionary power in implementing welfare policies, scholars of the administrative burden concept have only recently begun to consider their individual impacts on welfare recipients' experiences of onerous state encounters. This...

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...

This study examines the impact of caseworker beliefs on employment and health outcomes among long-term unemployed social assistance recipients in Denmark. Exploiting as-if random caseworker assignment, an instrumental variables approach, and a novel measure of "Caseworker Job Orientation", we...

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...

This study examines how SNAP participation may affect age-related cognitive decline among cognitively intact older adults over 10 years. Leveraging a longitudinal survey of SNAP-eligible participants in the Health and Retirement Study (HRS) collected biennially from 2010 to 2020, we estimate the...

This study examines how SNAP participation may affect age-related cognitive decline among cognitively intact older adults over 10 years. Leveraging a longitudinal survey of SNAP-eligible participants in the Health and Retirement Study (HRS) collected biennially from 2010 to 2020, we estimate the...

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...

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...

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...

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...

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...

This paper investigates the impact of geographic access on the take-up of the five largest social security programs in Israel using a staggered DiD design. These programs vary in their degree of administrative burden, ranging from a targeted program such as disability benefits to an automatic...

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...

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...

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...

The Medicaid coverage “cliff” occurs when Medicare beneficiaries with household income exceeding 100% of the federal poverty level lose eligibility for supplemental Medicaid coverage. Using a regression discontinuity design, we demonstrate that the cliff decreases the number of emergency...

Despite the controversy, states continue to implement Medicaid waivers which pair healthy behavior incentives with cost-sharing responsibilities. The empirical evidence, which has largely ignored implementation differences between states, has not found that these waivers increase healthy...

Experiments conducted in the mid-1990s show that a combination of work requirements and work supports substantially increased the employment of cash assistance recipients in Aid to Families with Dependent Children, the predecessor program to Temporary Assistance for Needy Families (TANF) while...

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...

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...