scholarly journals The Impact of Medicaid on Labor Market Activity and Program Participation: Evidence from the Oregon Health Insurance Experiment

2014 ◽  
Vol 104 (5) ◽  
pp. 322-328 ◽  
Author(s):  
Katherine Baicker ◽  
Amy Finkelstein ◽  
Jae Song ◽  
Sarah Taubman
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Food Stamps ◽  
Program Participation ◽  
Percentage Points ◽  
Randomized Design ◽  
Oregon Health ◽  
The Impact ◽  
Government Benefits ◽  
Labor Market Activity

In 2008, a group of uninsured low-income adults in Oregon was selected by lottery for the chance to apply for Medicaid. Using this randomized design and 2009 administrative data, we find no significant effect of Medicaid on employment or earnings. Our 95 percent confidence intervals allow us to reject that Medicaid causes a decline in employment of more than 4.4 percentage points, or an increase of more than 1.2 percentage points. Medicaid increases food stamps receipt, but has little, if any, impact on receipt of other measured government benefits, including SSDI.

scholarly journals Food Stamp Participation Among Low-Income Households: Theoretical Considerations of the Impact on the Demand for Food

1975 ◽  
Vol 7 (1) ◽  
pp. 223-231 ◽  
Author(s):  
Ron Mittelhammer ◽  
Donald A. West
Keyword(s):  
World War Ii ◽  
Low Income ◽  
The United States ◽  
Food Stamps ◽  
Food Stamp ◽  
World War ◽  
On Demand ◽  
The Impact ◽  
Theoretical Considerations ◽  
Direct Distribution

The USDA's Food Stamp Program (FSP) is a major item in the department's budget. In effect from 1939 to 1943 and revived as a pilot program in 1961, FSP has grown until, in 1973, it provided nearly $4 billion in food stamps to an average of 12 million persons per month. About 55 percent of the $4 billion is federal subsidy. The program is continuing to expand as a result of a congressional mandate that FSP be in effect nationwide after June 30, 1974. Because of the FSP's growth, questions are now being asked about the program's impact on demand for food in the United States.In its pre-World War II inception, FSP was developed as an alternative to direct distribution of commodities to relief families. Although the objective of improving food consumption among needy households was recognized, FSP was viewed primarily as a method for stimulating demand for farm products.

scholarly journals Catastrophic health expenditure incidence and its equity in China: a study on the initial implementation of the medical insurance integration system

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Huan Liu ◽  
Hong Zhu ◽  
Jiahui Wang ◽  
Xinye Qi ◽  
Miaomiao Zhao ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Low Income ◽  
Health Expenditure ◽  
Concentration Index ◽  
Medical Insurance ◽  
Catastrophic Health Expenditure ◽  
Integration System ◽  
Integration Policies ◽  
The Impact

Abstract Background By 2013, several regions in China had introduced health insurance integration policies. However, few studies addressed the impact of medical insurance integration in China. This study investigates the catastrophic health expenditure and equity in the incidence of catastrophic health expenditure by addressing its potential determinants in both integrated and non-integrated areas in China in 2013. Methods The primary data are drawn from the fifth China National Health Services Survey in 2013. The final sample comprises 19,788 households (38.4%) from integrated areas and 31,797 households (61.6%) from non-integrated areas. A probit model is employed to decompose inequality in the incidence of catastrophic health expenditure in line with the methodology used for decomposing the concentration index. Results The incidence of catastrophic health expenditure in integrated areas is higher than in non-integrated areas (13.87% vs. 13.68%, respectively). The concentration index in integrated areas and non-integrated areas is − 0.071 and − 0.073, respectively. Average household out-of-pocket health expenditure and average capacity to pay in integrated areas are higher than those in non-integrated areas. However, households in integrated areas have lower share of out-of-pocket expenditures in the capacity to pay than households in non-integrated areas. The majority of the observed inequalities in catastrophic health expenditure can be explained by differences in the health insurance and householders’ educational attainment both in integrated areas and non-integrated areas. Conclusions The medical insurance integration system in China is still at the exploratory stage; hence, its effects are of limited significance, even though the positive impact of this system on low-income residents is confirmed. Moreover, catastrophic health expenditure is associated with pro-poor inequality. Medical insurance, urban-rural disparities, the elderly population, and use of health services significantly affect the equity of catastrophic health expenditure incidence and are key issues in the implementation of future insurance integration policies.

scholarly journals The impact of participation in employment-based retirement savings plans on material hardship

2015 ◽  
Vol 15 (4) ◽  
pp. 407-428
Author(s):  
BRADLEY T. HEIM ◽  
SHANTHI P. RAMNATH
Keyword(s):  
Income Distribution ◽  
Low Income ◽  
Positive Impact ◽  
Retirement Savings ◽  
Program Participation ◽  
Material Hardship ◽  
Short Term ◽  
Financial Difficulties ◽  
Using Data ◽  
The Impact

AbstractTo contribute to a retirement plan (barring an increase in income), an individual must either reduce consumption or increase debt. Using data from the 2004 wave of the Survey of Income and Program Participation, we examine the extent to which contributing to 401(k)-type accounts leads to an increase in short-term financial difficulties, particularly among low-income individuals. After instrumenting for plan take-up, we find that contributing to a 401(k) plan appears to have a small positive impact on the presence of any material hardship and debt holding among the lowest income quintiles, though that effect diminishes further up the income distribution.

The Incidence of Health Shocks, Formal Health Insurance, and Informal Coping Mechanisms

2016 ◽  
Vol 15 (6) ◽  
pp. 665-695
Author(s):  
Samuel Amponsah
Keyword(s):  
Developing Countries ◽  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Household Survey ◽  
Health Insurance Coverage ◽  
Coping Mechanisms ◽  
Health Shocks ◽  
Economics Of Health ◽  
The Impact

In recent years, both theoretical and empirical research has accumulated in development economics literature regarding household behavior in response to shocks in developing countries. The literature especially has explored deeply the impact of weather-related shocks—such as droughts and floods—and the efficiency of informal mechanisms to cope with these shocks. In sharp contrast, our knowledge on the economics of health shocks in low-income developing countries is rather limited. A few studies have documented that low incomes and poor health insurance coverage account for catastrophic medical expenditures in the event of a health shock. This study uses a combination of Ghanaian household survey datasets to examine the different coping mechanisms employed by uninsured households to protect themselves from the incidence of health shocks. In addition, it explores the impact of formal health insurance (the National Health Insurance Scheme) on households’ out-of-pocket spending and catastrophic health expenditures.

scholarly journals COVID-19 Policy Differences across US States: Shutdowns, Reopening, and Mask Mandates

2020 ◽  
Vol 17 (24) ◽  
pp. 9520
Author(s):  
Xue Zhang ◽  
Mildred E. Warner
Keyword(s):  
Growth Rate ◽  
Health Insurance ◽  
Low Income ◽  
Minority Groups ◽  
State Level ◽  
State Governments ◽  
Access To Health ◽  
Short Period ◽  
The Us ◽  
The Impact

This work used event study to examine the impact of three policies (shutdowns, reopening, and mask mandates) on changes in the daily COVID-19 infection growth rate at the state level in the US (February through August 2020). The results show the importance of early intervention: shutdowns and mask mandates reduced the COVID-19 infection growth rate immediately after being imposed statewide. Over the longer term, mask mandates had a larger effect on flattening the curve than shutdowns. The increase in the daily infection growth rate pushed state governments to shut down, but reopening led to significant increases in new cases 21 days afterward. The results suggest a dynamic social distancing approach: a shutdown for a short period followed by reopening, combined with universal mask wearing. We also found that the COVID-19 growth rate increased in states with higher percentages of essential workers (during reopening) and higher percentages of minorities (during the mask mandate period). Health insurance access for low-income workers (via Medicaid expansion) helped to reduce COVID-19 cases in the reopening model. The implications for public health show the importance of access to health insurance and mask mandates to protect low-income essential workers, but minority groups still face a higher risk of infection during the pandemic.

scholarly journals The Impacts of Medicaid Expansion on Rural Low-Income Adults: Lessons From the Oregon Health Insurance Experiment

2017 ◽  
Vol 75 (3) ◽  
pp. 354-383 ◽  
Author(s):  
Heidi Allen ◽  
Bill Wright ◽  
Lauren Broffman
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Health Care Access ◽  
Rural Areas ◽  
Qualitative Interviews ◽  
Rural Populations ◽  
Controlled Study ◽  
Rural And Urban ◽  
Patient Resources ◽  
Oregon Health

Medicaid expansions through the Affordable Care Act began in January 2014, but we have little information about what is happening in rural areas where provider access and patient resources might be more limited. In 2008, Oregon held a lottery for restricted access to its Medicaid program for uninsured low-income adults not otherwise eligible for public coverage. The Oregon Health Insurance Experiment used this opportunity to conduct the first randomized controlled study of a public insurance expansion. This analysis builds off of previous work by comparing rural and urban survey outcomes and adds qualitative interviews with 86 rural study participants for context. We examine health care access and use, personal finances, and self-reported health. While urban and rural populations have unique demographic profiles, rural populations appear to have benefited from Medicaid as much as urban. Qualitative interviews revealed the distinctive challenges still facing low-income uninsured and newly insured rural populations.

Dentistry and Childhood Poverty in the United States

2012 ◽  
Vol 37 (1) ◽  
pp. 113-116 ◽  
Author(s):  
HB Waldman ◽  
D Cannella ◽  
SP Perlman
Keyword(s):  
United States ◽  
Health Insurance ◽  
Low Income ◽  
The United States ◽  
Dental Services ◽  
Childhood Poverty ◽  
Low Income Families ◽  
The Impact ◽  
Localized Levels

The proportion and numbers of children living in low income families and without health insurance continues to increase. The magnitude of these problems is considered at localized levels in terms of the impact on the use of dental services.

An Economic Model to Analyze the Impact of False Claims Act Cases on Access to Healthcare for the Elderly, Disabled, Rural and Inner-City Poor

2001 ◽  
Vol 27 (4) ◽  
pp. 439-467
Author(s):  
Dayna Bowen Matthew
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
The Elderly ◽  
Access To Healthcare ◽  
Nursing Home Care ◽  
War On Poverty ◽  
The Social ◽  
Social Security Act ◽  
The Disabled ◽  
The Impact

In 1964 President Lyndon B. Johnson declared a “War on Poverty.” By 1965 Congress had enacted several key weapons in that war, including two massive revisions to the Social Security Act designed to provide broad access to healthcare for if. the elderly, the disabled and poor, uninsured pregnant women and infants. The current Medicare and Medicaid health insurance programs, along with the State Children's Health Insurance Program, provide health insurance and thus, access to healthcare, for 60% of people living in poverty. Medicaid alone pays for half of all nursing home care in this country. Medicare pays for hospital care for over 32.4 million elderly Americans, and for 3.7 million disabled Americans. Medicare and Medicaid have been called the “lynch pin” in the nation's strategy to assure access to healthcare for low income Americans. In short, the War on Poverty is not effective without the access to healthcare Medicare and Medicaid afford to the poor, elderly and disabled.

scholarly journals The Impact of i-PUSH on Maternal and Child Health Outcomes, Health Care Utilization and Financial Protection: A Cluster Randomised Controlled Trial Based on Financial and Health Diaries Data

2020 ◽  
Author(s):  
Amanuel Abajobir ◽  
Richard de Groot ◽  
Caroline Wainaina ◽  
Anne Njeri ◽  
Daniel Maina ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Low Income ◽  
Health Knowledge ◽  
Care Utilization ◽  
Quality Health ◽  
Randomised Controlled ◽  
The Impact ◽  
Quality Health Services

Abstract Background: Universal Health Coverage (UHC) ensures access to quality health services for all, with no financial hardship when accessing the needed services. Nevertheless, access to quality health services is marred by substantial resource shortages creating service delivery gaps in low-and middle-income countries (LMICs), including Kenya. The Innovative Partnership for Universal Sustainable Healthcare (i-PUSH) program, developed by AMREF Health Africa and PharmAccess Foundation (PAF), aims to empower low-income women of reproductive age and their families through innovative digital tools. This study aims to evaluate the impact of i-PUSH on maternal and child health care utilization, women’s health including their knowledge, behavior and uptake of respective services, as well as women’s empowerment and financial protection. It also aims to evaluate the impact of the LEAP training tool on empowering and enhancing CHVs’ health literacy and to evaluate the impact of the M-TIBA health wallet on savings for health and health insurance uptake.Methods: This is a cluster randomised controlled trial (RCT) study that uses a four-pronged approach –including year-long weekly financial and health diaries interviews, baseline and endline surveys, a qualitative study and behavioral lab-in-the-field experiments–in Kakemega County, Kenya. In total, 240 households from 24 villages in Kakamega will be followed to capture their health, health knowledge, health-seeking behavior, health expenditures and enrolment in health insurance over time. A random half of the households live in villages assigned to the treatment group where i-PUSH will be implemented after the baseline, while the other half of the households live in control village where i-PUSH will not be implemented until after the endline. The study protocol was reviewed and approved by the AMREF Ethical and Scientific Review Board (AMREF-ESRC). Research permits were obtained from the National Commission for Science, Technology and Innovation (NACOSTI) agency of Kenya. Discussion: People in LMICs often suffer from high out-of-pocket healthcare expenditures, which in turn, impedes access to quality health services. Saving for healthcare as well as enrolment in health insurance can improve access to healthcare by building capacities at all levels–individuals, families and communities. Notable, i-PUSH fosters savings for health care through the mobile-phone based “health wallet”, it enhances enrolment in subsidized health insurance through the mobile platform–M-TIBA–developed by PAF, and it seeks to improve health knowledge and behavior through Community Health Volunteers (CHVs) who are trained using the LEAP tool–AMREF’s mHealth platform. The findings will inform stakeholders to formulate better strategies to ensure access to UHC in general, and for a highly vulnerable segment of the population in particular, including low-income mothers and their children. Trial registration history: Registered with Protocol Registration and Results System (Protocol ID: AfricanPHRC; Trial ID: NCT04068571: AEARCTR-0006089; Date: 29 August 2019) and The American Economic Association's registry for randomised controlled trials (Trial ID: AEARCTR-0006089; Date: 26 June 2020).

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