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Papers Containing Keywords(s): 'medicaid'

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Viewing papers 1 through 10 of 47


  • Working Paper

    Screening Out the Needy: the Effects of SNAP Work Requirements

    July 2026

    Working Paper Number:

    CES-26-46

    We examine the effectiveness of work requirements as a screening device in the Supplemental Nutrition Assistance Program (SNAP). Work requirements for 'able-bodied adults without dependents' were suspended after the Great Recession and gradually reinstated across counties and states in the 2010s. Using linked administrative SNAP and employment data from five states and a triple-differences design, we find that work requirements reduce SNAP participation by seven percent without increasing labor supply and disproportionately screen out low-income individuals. We develop a welfare framework to interpret these results and find that the social costs of work requirements exceed budget savings.
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  • Working Paper

    Access to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) at the State and Substate Levels: Meaning and Measurement

    July 2026

    Working Paper Number:

    CES-26-44

    This study estimates eligibility and access rates for the U.S. Department of Agriculture's (USDA) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) administrative data linked with American Community Survey (ACS) data. This study is one result of a long-term research collaboration among USDA's Economic Research Service; the U.S. Department of Commerce, Bureau of the Census; USDA's Food and Nutrition Service (FNS); and participating state WIC agencies.'By analyzing WIC participation at the state and substate levels, the report provides insights into program reach and demographic differences. The findings confirm that the Census Bureau estimates meet high statistical reliability standards, providing valuable data for program officials and managers, and other stakeholders, to enhance program outreach and effectiveness. A key focus of the report is the comparison between Census Bureau and USDA, FNS estimates, which differ in methodology and measurement scope.
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  • Working Paper

    Integrating Administrative and Survey Data to Estimate WIC Eligibility and Access

    July 2026

    Working Paper Number:

    CES-26-43

    The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides benefits to low-income, nutritionally at-risk women, infants, and children. To administer WIC, officials and program managers at the federal and state level want to understand who is eligible for the program, who among the eligible population chooses to participate, and who is not accessing the program despite their eligibility. Novel individual-level data linkages between restricted-use WIC Administrative Records and the American Community Survey provide WIC access rates estimated at the state and county levels, as well as estimates disaggregated by the demographic and socioeconomic characteristics of individuals and their households. These estimates are developed by the Census-FNS-ERS Joint Project, a research partnership among the U.S. Census Bureau, the US Department of Agriculture's Food and Nutrition Service and Economic Research Service, and state WIC agencies that provide the requisite WIC administrative data to the Census Bureau. This paper details and evaluates our current data linkage and estimation methods, reports results, and identifies areas for improvement and further research.
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  • Working Paper

    The Impact of Expanding Public Health Insurance on Safety Net Program Participation: Evidence From the ACA Medicaid Expansion

    May 2026

    Working Paper Number:

    CES-26-32

    We examine spillover effects from the ACA Medicaid expansion to public programs providing cash and food assistance. We consider program participation in contiguous county pairs crossing state borders, where one state took up the Medicaid expansion and the other did not, allowing us to better control for local economic trends that could affect program participation. We find that the Medicaid expansion increased participation in food assistance and one of the cash programs, with impacts mainly due to participation conditional on eligibility, rather than from labor supply responses. Our results demonstrate the potential for spillovers across safety net programs.
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  • Working Paper

    The Mortality Risk of Raising Grandchildren in the United States

    February 2026

    Working Paper Number:

    CES-26-13

    In the United States, grandparents who live with and provide primary care to their grandchildren have emerged as a particularly vulnerable group since the 1990s. Using confidential data from the U.S. Census Bureau and Social Security Administration, this study linked individuals aged 50 years or older from the 2000 census long-form sample to their death records from 2000'2019 (weighted n = 64,027,000) and examined the longitudinal association between coresident grandparenting status and mortality for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, and Asians. We found consistently higher rates of mortality for White coresident grandparents and lower rates for Asian coresident grandparents, regardless of the duration of primary caregiving, compared to their peers without coresident grandchildren. We also found increased risks of mortality among Hispanic long-term primary caregivers but reduced risks among Black short-term primary caregivers, compared to their peers without coresident grandchildren.
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  • Working Paper

    The Design of Sampling Strata for the National Household Food Acquisition and Purchase Survey

    February 2025

    Working Paper Number:

    CES-25-13

    The National Household Food Acquisition and Purchase Survey (FoodAPS), sponsored by the United States Department of Agriculture's (USDA) Economic Research Service (ERS) and Food and Nutrition Service (FNS), examines the food purchasing behavior of various subgroups of the U.S. population. These subgroups include participants in the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), as well as households who are eligible for but don't participate in these programs. Participants in these social protection programs constitute small proportions of the U.S. population; obtaining an adequate number of such participants in a survey would be challenging absent stratified sampling to target SNAP and WIC participating households. This document describes how the U.S. Census Bureau (which is planning to conduct future versions of the FoodAPS survey on behalf of USDA) created sampling strata to flag the FoodAPS targeted subpopulations using machine learning applications in linked survey and administrative data. We describe the data, modeling techniques, and how well the sampling flags target low-income households and households receiving WIC and SNAP benefits. We additionally situate these efforts in the nascent literature on the use of big data and machine learning for the improvement of survey efficiency.
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  • Working Paper

    Nonresponse and Coverage Bias in the Household Pulse Survey: Evidence from Administrative Data

    October 2024

    Working Paper Number:

    CES-24-60

    The Household Pulse Survey (HPS) conducted by the U.S. Census Bureau is a unique survey that provided timely data on the effects of the COVID-19 Pandemic on American households and continues to provide data on other emergent social and economic issues. Because the survey has a response rate in the single digits and only has an online response mode, there are concerns about nonresponse and coverage bias. In this paper, we match administrative data from government agencies and third-party data to HPS respondents to examine how representative they are of the U.S. population. For comparison, we create a benchmark of American Community Survey (ACS) respondents and nonrespondents and include the ACS respondents as another point of reference. Overall, we find that the HPS is less representative of the U.S. population than the ACS. However, performance varies across administrative variables, and the existing weighting adjustments appear to greatly improve the representativeness of the HPS. Additionally, we look at household characteristics by their email domain to examine the effects on coverage from limiting email messages in 2023 to addresses from the contact frame with at least 90% deliverability rates, finding no clear change in the representativeness of the HPS afterwards.
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  • Working Paper

    Incorporating Administrative Data in Survey Weights for the 2018-2022 Survey of Income and Program Participation

    October 2024

    Working Paper Number:

    CES-24-58

    Response rates to the Survey of Income and Program Participation (SIPP) have declined over time, raising the potential for nonresponse bias in survey estimates. A potential solution is to leverage administrative data from government agencies and third-party data providers when constructing survey weights. In this paper, we modify various parts of the SIPP weighting algorithm to incorporate such data. We create these new weights for the 2018 through 2022 SIPP panels and examine how the new weights affect survey estimates. Our results show that before weighting adjustments, SIPP respondents in these panels have higher socioeconomic status than the general population. Existing weighting procedures reduce many of these differences. Comparing SIPP estimates between the production weights and the administrative data-based weights yields changes that are not uniform across the joint income and program participation distribution. Unlike other Census Bureau household surveys, there is no large increase in nonresponse bias in SIPP due to the COVID-19 Pandemic. In summary, the magnitude and sign of nonresponse bias in SIPP is complicated, and the existing weighting procedures may change the sign of nonresponse bias for households with certain incomes and program benefit statuses.
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  • Working Paper

    Measuring Income of the Aged in Household Surveys: Evidence from Linked Administrative Records

    June 2024

    Working Paper Number:

    CES-24-32

    Research has shown that household survey estimates of retirement income (defined benefit pensions and defined contribution account withdrawals) suffer from substantial underreporting which biases downward measures of financial well-being among the aged. Using data from both the redesigned 2016 Current Population Survey Annual Social and Economic Supplement (CPS ASEC) and the Health and Retirement Study (HRS), each matched with administrative records, we examine to what extent underreporting of retirement income affects key statistics such as reliance on Social Security benefits and poverty among the aged. We find that underreporting of retirement income is still prevalent in the CPS ASEC. While the HRS does a better job than the CPS ASEC in terms of capturing retirement income, it still falls considerably short compared to administrative records. Consequently, the relative importance of Social Security income remains overstated in household surveys'53 percent of elderly beneficiaries in the CPS ASEC and 49 percent in the HRS rely on Social Security for the majority of their incomes compared to 42 percent in the linked administrative data. The poverty rate for those aged 65 and over is also overstated'8.8 percent in the CPS ASEC and 7.4 percent in the HRS compared to 6.4 percent in the linked administrative data. Our results illustrate the effects of using alternative data sources in producing key statistics from the Social Security Administration's Income of the Aged publication.
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  • Working Paper

    The Long-Term Effects of Income for At-Risk Infants: Evidence from Supplemental Security Income

    March 2024

    Working Paper Number:

    CES-24-10

    This paper examines whether a generous cash intervention early in life can "undo" some of the long-term disadvantage associated with poor health at birth. We use new linkages between several large-scale administrative datasets to examine the short-, medium-, and long-term effects of providing low-income families with low birthweight infants support through the Supplemental Security Income (SSI) program. This program uses a birthweight cutoff at 1200 grams to determine eligibility. We find that families of infants born just below this cutoff experience a large increase in cash benefits totaling about 27%of family income in the first three years of the infant's life. These cash benefits persist at lower amounts through age 10. Eligible infants also experience a small but statistically significant increase in Medicaid enrollment during childhood. We examine whether this support affects health care use and mortality in infancy, educational performance in high school, post-secondary school attendance and college degree attainment, and earnings, public assistance use, and mortality in young adulthood for all infants born in California to low-income families whose birthweight puts them near the cutoff. We also examine whether these payments had spillover effects onto the older siblings of these infants who may have also benefited from the increase in family resources. Despite the comprehensive nature of this early life intervention, we detect no improvements in any of the study outcomes, nor do we find improvements among the older siblings of these infants. These null effects persist across several subgroups and alternative model specifications, and, for some outcomes, our estimates are precise enough to rule out published estimates of the effect of early life cash transfers in other settings.
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