“Health Insurance Coverage for Displaced Workers Before and After the Affordable Care Act” (with Mariana Zerpa)
Under Review. NBER working paper # 34874
We examine how the Affordable Care Act (ACA) altered the insurance consequences of involuntary job loss. Using matched event-study models with longitudinal survey data, we estimate the causal effects of displacement on insurance coverage before and after implementation of the ACA's main provisions. Prior to 2014, job loss reduced coverage by approximately 16 percentage points, with losses persisting for more than a year. After the ACA, declines are smaller—about 10 percentage points—and recovery is faster. Gains reflect higher baseline public coverage and reduced post-displacement losses, with the largest improvements among middle-income workers previously most exposed to coverage disruptions.
“Local Labor Demand and Achievement Gaps: Evidence from the Great Recession” (with Karla Cordova)
Under Review.
We examine how contractions in local labor demand during the Great Recession affected children's academic achievement. We combine county-level test scores for grades 3–8 from the Stanford Education Data Archive with a shift-share design that interacts counties' 2005 industry composition with national industry employment growth, isolating demand-driven changes in local employment. Following recent advances in the shift-share literature, we validate the design with balance, pre-trend, and Rotemberg-weight diagnostics and report exposure-robust standard errors throughout. A one-standard-deviation adverse shock lowers mathematics achievement by about 0.03 student-level standard deviations and widens the White–Black and economic-disadvantage achievement gaps in both subjects. Within a common geography, losses concentrate among economically disadvantaged students. English language arts estimates point in the same direction but are harder to separate from the Great Recession's housing bust, and we interpret them as the combined effect of the labor-demand contraction and the associated decline in house prices. The achievement response is concentrated in the recession window. The post-2014 period, identified mainly by the oil-price cycle, yields a precise null, so our estimates measure the response to severe contractions rather than a general business-cycle parameter. School funding did not respond contemporaneously to these shocks, while family income, child poverty, and house prices all did.
“Who Bears the Burden of Dementia? Wealth, Family, and the Provision of Long-Term Care” (with Chase Eck)
In Progress.
Long-term-care risk is largely uninsured in the United States. Households facing dementia rely on private wealth, on family caregivers, and, once wealth is exhausted, on Medicaid. Using more than two decades of panel data from the Health and Retirement Study, we estimate event studies of care use, care financing, and family support around dementia onset, which we date from cognitive assessments rather than clinical diagnosis. Dementia raises care hours and out-of-pocket spending by more than any other major old-age health shock. Adult children supply much of the response. Their caregiving hours triple following a parent's onset, and within two years more than half of households with children have a child providing care. Wealth and family structure determine how the burden is borne. Households with children substitute toward informal care and spend less out of pocket, wealthy childless households purchase market care, and households with neither receive the least care relative to need, report the most unmet needs, and rely most heavily on Medicaid. As family sizes decline, the burden of dementia will shift toward private wealth and public programs.