Health insurance expansions can exert wellbeing effects on individuals who provide informal care to their loved ones, reducing their experience of depression. This study exploits evidence from the Affordable Care Act’s Medicaid expansion (ACA Medicaid) to examine the effects on the mental wellbeing of informal caregivers. Drawing on an event study and a Difference-in-Differences (DID) design we investigate the policy impact of ACA Medicaid using longitudinal evidence (from the Health and Retirement Study, HRS) for low-income individuals aged 64 or below. We find that ACA’s Medicaid reduced depressive symptoms among spousal caregivers, and specifically we estimate that exposure to ACA Medicaid gives rise to 8.2% points (on average, equivalent to 30% decrease) reduction in the feeling of depression and 8.7% points increase in the feeling of happiness (on average, 11% increase). The estimates are robust to various specifications, and we identify several potential driving mechanisms for the findings: reductions in out of -pocket expenses and labor supply and, as expected, increased after Medicaid uptake. The evidence from falsification tests confirms that the estimated effects are likely due to ACA’s Medicaid.

This paper introduces the R package edgar to download and analyze the Securities and Exchange Commission’s (SEC) mandatory public disclosures in the United States. Corporations in the U.S. submit their periodic reports, registration statements, and financial reports electronically to the SEC. The SEC makes these reports publicly accessible to everyone through the Electronic Data Gathering, Analysis, and Retrieval System (EDGAR). As financial reporting is one of the most crucial aspects of the financial system, efficient retrieval of EDGAR filings becomes imperative for analysts and researchers. We summarize the implementation of the edgar package that facilitates downloading, parsing, searching, and sentiment analysis of corporate reports.

Can the expansion of Medicaid, a means-tested health and long-term care insurance, be slowed down by incentivising the purchase of private long-term care insurance (LTCI)? We study the implementation of the long-term care insurance partnership (LTCIP) program, a joint federal and state-level program that intended to promote LTCI coverage. Drawing on a difference-in-differences (DD) design we study the effect of the rollout of the LTCIP program between 2005 and 2016 on both LTCI uptake and Medicaid eligibility, and we estimate the effect on Medicaid savings. Drawing on a difference-in-differences (DD) design, we find that, unlike previous estimates, LTCIP does significantly increases LTCI coverage, and reduces the uptake of Medicaid. The effects are driven by the introduction of LTCIP in states after 2010 (not covered in previous studies). We estimate that the adoption of LTCIP has given rise to an average Medicaid saving of $36 for every 65-year-old. This suggests scope for LTCI arrangements to reduce Medicaid spending.

The financing of long-term care services and supports (LTSS) for most Americans relies heavily on self-insurance either via housing or financial wealth at old age. We examine the effect of wealth shocks resulting from changes in both housing values, and shocks to the value of other assets on the uptake of private long-term care insurance (LTCI) and on the individual eligibility for Medicaid. Using restricted data from the relevant waves of the Health and Retirement Study (1994-2018), we explore local market variation in housing prices and, individual variation US stock market wealth. Consistent with the hypothesis of a self-insurance care effect’, we document that positive housing price and stock wealth shocks significantly reduce the probability of purchasing private-LTCI without significantly altering Medicaid eligibility among owners of housing and financial assets. We find that the effect of shocks to liquid wealth strongly dominates the effect of housing wealth changes. A $100,000 increase in financial (housing) wealth reduces the likelihood of buying private-LTCI by 4.7 (0.6) percentage points.

Does the uptake of long-term care insurance (LTCI – both public and private) alter economic activity in later life? I present evidence on how individuals adjust to their expectation of the need of long-term care at older age and how LTCI affects the labor participation of elderly population in the US. I take advantage of the variation that comes from the adoption of state level reforms, introduced for incentivizing the uptake of private-LTCI, to identify the effect of uptake of LTCI on labor outcomes and savings behavior. I use 12 waves of restricted data from Health and Retirement Study survey data from year 1996-2018. I find that the uptake of LTCI is associated with decrease in labor participation, both intensive and extensive margins. Most importantly, I observe that the uptake LTCI reduces weekly workhours by almost 8 hours and weeks per year by 0.25 weeks. In addition, I identify important mechanisms that drive the effect. These estimates are robust to various specification checks.