Publications    

The Impact of Financial Assistance Programs on Health Care Utilization (with Alyce Adams, Raymond Kluender, Neale Mahoney, Jinglin Wang, and Wesley Yin) American Economic Review: Insights 4(3), September 2022: 389-407.

Trends in Medical Debt During the COVID-19 Pandemic (with Benedict Guttman-Kenney, Raymond Kluender, Neale Mahoney, Xuyang Xia, and Wesley Yin) JAMA Health Forum 3(5):e221031, May 2022.

Medical Debt in the US, 2009-2020 (with Raymond Kluender, Neale Mahoney, and Wesley Yin) JAMA 326(3), July 2021.

Press Coverage: New York Times, Washington Post, Vox, MarketWatch, CBS, Marketplace

Working Papers

The Effects of Medical Debt Relief: Evidence from Two Randomized Experiments (with Raymond Kluender, Neale Mahoney, and Wesley Yin)

Links: NBER Working Paper no. 32315

Abstract: Two in five Americans have medical debt, nearly half of whom owe at least $2,500. Concerned by this burden, governments and private donors have undertaken large, high-profile efforts to relieve medical debt. We partnered with RIP Medical Debt to conduct two randomized experiments that relieved medical debt with a face value of $169 million for 83,401 people between 2018 and 2020. We track outcomes using credit reports, collections account data, and a multimodal survey. There are three sets of results. First, we find no impact of debt relief on credit access, utilization, and financial distress on average. Second, we estimate that debt relief causes a moderate but statistically significant reduction in payment of existing medical bills. Third, we find no effect of medical debt relief on mental health on average, with detrimental effects for some groups in pre-registered heterogeneity analysis.

Press Coverage: New York Times, Vox, The Guardian, Forbes

Racial Disparities in Housing Returns (with Amir Kermani)

Links: NBER Working Paper no. 29306

Abstract: We document the existence of a racial gap in realized housing returns that is an order of magnitude larger than disparities arising from housing costs alone, and is driven by differences in distressed home sales (i.e., foreclosures and short sales). Black and Hispanic homeowners are both more likely to experience a distressed sale and to live in neighborhoods where distressed sales erase more house value. However, absent financial distress, houses owned by minorities do not appreciate at substantially slower rates than houses owned by non-minorities. Racial differences in liquid wealth and income stability are important determinants of differences in distress.

Press Coverage: Mother Jones

Taxing Homeowners Who Won't Borrow

Abstract: Standard economic models assume homeowners are willing and able to borrow against their housing wealth. I use high-frequency administrative data and quasi-experimental variation in property taxes to show that because homeowners do not borrow, property taxes exacerbate consumption volatility and financial distress. This behavior occurs even among homeowners with access to credit, ruling out standard credit-supply constraints. Instead, a new household survey indicates that preference-based debt aversion deters borrowing. Additional efficiency costs arise because property taxes increase foreclosures and decrease home investment, which imply negative externalities as well as distortions to the tax base. Property taxes also displace homeowners to lower-quality neighborhoods. Together, these findings reveal the existence of important and previously-unmodeled welfare costs.

Mad as Hell: Property Taxes and Financial Distress

Abstract: Property taxes are uniquely unpopular and have been curtailed in 46 US states. This study tests whether property tax animus occurs when rising home values raise tax bills and create financial distress. Consistent with this channel, property taxes are more unpopular when governments do not limit how much rising home values can raise taxes. Financial distress is a key correlate of property tax animus in both survey responses and real-world voting behavior. Randomized information treatments indicate that distortionary income-based tax relief reduces property tax animus, suggesting that politically sustainable property taxes require distortionary modifications that mitigate financial distress.