Health, Health Insurance and Employment: A Dynamic Model (Job Market Paper)

This paper studies the complex feedback loop of health status, health insurance and employment status. Using a discrete choice dynamic programming model where working-age men make employment decisions each period, I model the effect of a health shock on an individual's choice to continue working or to enter or exit the labor force. If he chooses to work, he may not find a job and instead be unemployed. His labor force status, in turn, impacts his probability of health insurance coverage, as well as his subsequent health status. Data from the Panel Study of Income Dynamics (PSID) from 1999-2015 is used to estimate the model. Counterfactual analyses show that expanding health insurance to all individuals slightly improves overall health but decreases labor force participation. Insurance affects employment decisions through health and expected out-of-pocket medical expenditures. Healthy men obtain more utility from working than not working and have higher wages than unhealthy men. Although there are more healthy individuals with higher wages, this is not enough to offset the negative effect from the increase in medical expenditures. This increase in medical expenditures only occurs for the unhealthy. Thus, the decline in labor force participation is driven by unhealthy men exiting full-time jobs, which provide insurance at higher rates than part-time jobs. This supports the theory that some individuals, particularly unhealthy ones, choose to work to obtain health insurance.

Consumer Plan Choice in the Florida Medicaid Market (with Yaroslav Kryukov)

In this paper, we model a patient’s plan decision in the Medicaid market in Florida. Since 2014, most Florida Medicaid recipients have been required to enroll in a Managed Medical Assistance plan. These plans are offered at no cost to the enrollee. All plans must offer the same core benefits but have varying extended benefits and physician networks. Using monthly plan and county specific enrollment data from the Florida Agency on Health Care Administration, we determine what Medicaid enrollees value most in a health insurance plan. We adapt a Berry, Levinsohn and Pakes (BLP 1995) random coefficients discrete choice demand model to our setting without prices and without an outside good. We find non-trivial effects of some plan characteristics on plan choice. The importance of these benefits varies by patient characteristics, including race.

Voting Persistence After Close Elections (with Rebecca Lessem and Carly Urban)

In this paper, we seek to understand persistence in voter turnout across election cycles. Specifically, we analyze how close state presidential elections influence future voting behavior of individuals and how this varies based on who the voter supported: a winner or a loser of a state electoral contest. It is likely that after the election, voters update their beliefs on the degree to which they influence on the state and therefore national election. The beliefs depend not only on whether or not one’s preferred candidate won the state Electoral College votes but also on the margin by which the candidate won or lost. Using data from the American National Election Studies (ANES), we use within state variation in voter turnout and Electoral College closeness from 1948-2012 to analyze individual voting behavior across election cycles. We compare individuals who voted for a candidate who barely lost to individuals in the same state who voted for a candidate who barely won the electoral votes for that state. The results suggest that, relative to consistent voters, voters in close state Electoral College contests are most likely to vote in the following election, when compared to those in less close races.