Brian Fischer

Contact Information:

283 Ash Street 

Waltham, MA 02453

Cell Phone: (607)-765-0460

E-mail: bfischer2@gmail.com



Resume



Areas of Specialization:    Macroeconomics, Econometrics, Public Finance, Health Economics



Working Papers:


Abstract: Nongroup health insurance reforms in the Patient Protection and Affordable Care Act of 2010 are studied using a general equilibrium life cycle model to assess the impact of excluding Medicaid expansion from the reform. The model includes earnings uncertainty, stochastic medical expenditure shocks and endogenous health insurance purchase decisions. The model is calibrated to match key moments of the U.S. economy and life cycle profiles in the Medical Expenditure Panel Survey data set. An expected welfare gain is achieved from the reform independent of Medicaid's expansion. The reforms reduce the percent uninsured from 22.5% in the baseline model to 6.8% when the reform includes Medicaid expansion, and 9.2% when Medicaid is not expanded. Due to exemptions provided in the law, less than 35% of the uninsured are subject to the individual mandate tax. Greater insurance coverage can be achieved if the mandate tax exemptions are eliminated, if subsidies are extended below the poverty level, or if community rating for nongroup insurance is excluded.

 



Abstract: This paper develops a general equilibrium life cycle model to study the effects of a Medicare voucher reform. The model is calibrated using data from the Medical Expenditure and Panel Survey. The reform is modeled to capture common features of past legislative proposals. Retirees receive a voucher, equal to the average subsidy currently received through the Medicare payroll tax, to apply towards medical care or insurance premiums. Medicaid's medically needy program reduces incentives for retirees to save and purchase insurance under the reform. With a voucher program group coverage applies to the full cost of retiree medical care, which increases the firms' cost of providing retirees health insurance. Welfare gains among newborns and agents entering retirement can be achieved if the voucher and Medicaid's medically needy program are available to only insured retirees, and if the reform includes a subsidy that limits out-of-pocket spending on Medicare premiums to 30% of income.



     3. "Reducing Medical Bankruptcies through Health Reform."


Abstract: An overlapping generations general equilibrium model with stochastic medical expenditure shocks and endogenous health insurance and bankruptcy decisions is used to study the effects of nongroup health insurance reform in the Patient Protection and Affordable Care Act (ACA) of 2010. The model is calibrated using household level survey data to match key moments observed in the data and in the literature. Relative to the baseline model, the reforms reduce the percent uninsured and significantly lower the incidence of medical bankruptcies. More modest reductions in the bankruptcy rate and medical bankruptcies occur when Medicaid is not expanded. Cost-sharing subsidies and the individual mandate exemptions are key components for reducing medical bankruptcies. In addition to the ACA reforms, further reductions in medical bankruptcies can be achieved through increasing the income eligibility limit for Medicaid's medically needy program.