Research

Abstract: In 2001, Germany abolished public occupational disability insurance (ODI)---the second tier of its public DI system---for cohorts born after 1960. Using administrative data, we first document that, in the long run, overall DI inflows declined by roughly one-third. Second, using representative survey data, we document at best modest ODI insurance take-up responses in the private individual, risk-rated market, which lacks guaranteed issue. Third, an equilibrium model incorporating interactions between the public safety net, the first-tier public DI, and the private market reveals that coverage denials and weak insurance demand, driven by complementary social insurance, can explain the modest private ODI take-up response. Coverage gradients by income and health are thus substantial. Finally, counterfactual simulations highlight the limited scope of incremental reforms.

Abstract: We use the National Longitudinal Study of Adolescent to Adult Health to explore how high school peers' grit, a personality trait characterized by perseverance and passion, influences long-term outcomes approximately 15 years after high school. Exploiting random variation within schools across cohorts and the longitudinal nature of our data, we find that peer grit significantly increases future earnings by 4.2%, especially for students from disadvantaged backgrounds. This implies that peer grit may help bridge socioeconomic gaps. We uncover three potential channels through which peer grit affects long-term earnings: college enrollment, job alignment with long-term career goals, and increased resilience to difficulties. Additionally, peer grit leads to higher job satisfaction and asset accumulation. Thus, peer grit's effects extend beyond short-term educational performance and persist into adulthood.

Abstract: This paper uses Utah All-payer Claims Data linked to earnings records to estimate an insurance demand model that jointly considers earnings dynamics and medical risk. Including earnings dynamics reduces the estimated insurance take-up rate by 14.7% and increases the premium by 3.8%. Heterogeneous earnings dynamics influence the willingness to pay (WTP) for health insurance, even among individuals with identical medical risks, thereby weakening the connection between expected medical costs and WTP. Simulations show that means-tested subsidies increase equilibrium take-up less than equivalently costly uniform subsidies. Combining public insurance expansion with means-tested subsidies significantly boosts welfare.

Abstract: This paper examines how limited Primary Care Network (PCN) coverage affects healthcare utilization and spending among previously uninsured individuals. Introduced in Utah in 2002, PCN provides primary and emergency care but excludes inpatient and specialty services to control costs. We construct a unique person-month administrative dataset covering the universe of inpatient, emergency, and ambulatory care encounters for all Utah residents from 2001 to 2005. Using event study models, we compare outcomes for newly covered individuals to those of traditional Medicaid enrollees. Over the 36 months following PCN enrollment, Emergency Department visits increase by 21%, inpatient admissions decline by 28%, and ambulatory hospital visits fall by 42%. Total hospital spending rises modestly---by about 6%---driven largely by care related to mental health.

Abstract: Using German Socio-Economic Panel and private health insurance claims, this paper estimates the causal effect of obesity on medical expenditures in Germany. Employing biological children’s BMI as an instrument for adult obesity, we find that obesity significantly increases medical expenditures. Findings remain robust by applying a Double Machine Learning framework to account for high-dimensional confounding and nonlinear relationships. This study provides novel cross-national evidence on the fiscal consequences of obesity.