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Who Values Human Capitalists' Human Capital? Healthcare Spending and Physician Earnings
July 2020
Working Paper Number:
CES-20-23
Is government guiding the invisible hand at the top of the labor market? We study this question among physicians, the most common occupation among the top one percent of income earners, and whose billings comprise one-fifth of healthcare spending. We use a novel linkage of population-wide tax records with the administrative registry of all physicians in the U.S. to study the characteristics of these high earnings, and the influence of government payments in particular. We find a major role for government on the margin, with half of direct changes to government reimbursement rates flowing directly into physicians' incomes. These policies move physicians' relative and absolute incomes more than any reasonable changes to marginal tax rates. At the same time, the overall level of physician earnings can largely be explained by labor market fundamentals of long work and training hours. Competing occupations also pay well and provide a natural lower bound for physician earnings. We conclude that government plays a major role in determining the value of physicians' human capital, but it is unrealistic to use this power to reduce healthcare spending substantially.
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High Labor Force Attachment, but Few Social Ties? Life-Course Predictors of Women's Receipt of Childcare Subsidies
September 2019
Working Paper Number:
CES-19-26
The U.S. federal Child Care and Development Fund (CCDF) childcare subsidy represents the largest source of means-tested assistance for U.S. families with low incomes. The CCDF subsidy aims to help mothers with low incomes gain employment and education, with implications for women's labor force participation, and the wellbeing of their children. Because recipients of the CCDF subsidy are either already employed, or seek the subsidy with the goal of gaining employment or schooling, this group may represent the public assistance recipients who are best able to succeed in the low-wage labor market. However, existing research on the CCDF observes recipients only after they begin receiving the subsidy, thus giving an incomplete picture of whether recipients may select into subsidy receipt, and how subsidy recipiency is situated in women's broader work and family trajectories. My study links administrative records from the CCDF to the American Community Survey (ACS) to construct a longitudinal data set from 38 states that observes CCDF recipients in the 1-2 years before they first received the subsidy. I compare women who subsequently received the CCDF subsidy to other women with low incomes in the ACS who did not go on to receive the subsidy, with a total of roughly 641,000 individuals. I find that CCDF recipients are generally positively-selected on employment history and educational attainment, but appear to have lower levels of social support than non-recipients.
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The Antipoverty Impact of the EITC: New Estimates from Survey and Administrative Tax Records
April 2019
Working Paper Number:
CES-19-14R
We reassess the antipoverty effects of the EITC using unique data linking the CPS Annual Social and Economic Supplement to IRS data for the same individuals spanning years 2005-2016. We compare EITC benefits from standard simulators to administrative EITC payments and find that significantly more actual EITC payments flow to childless tax units than predicted, and to those whose family income places them above official poverty thresholds. However, actual EITC payments appear to be target efficient at the tax unit level. In 2016, about 3.1 million persons were lifted out of poverty by the EITC, substantially less than prior estimates.
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The effect of child support on selection into marriage and fertility
February 2019
Working Paper Number:
CES-19-04
Child support policies in the United States have expanded dramatically since the mid-1970s and now cover 1 in 5 children. This paper studies the consequences of child support for marriage and fertility decisions. I first introduce a model showing that child support enforces ex ante commitment from men to provide financial support in the event of a child, which (1) increases premarital sex among couples unlikely to marry, and (2) reduces the abortion rate, by lessening the cost of raising a child as a single mom. Using variation in the timing and geography of the rollout of U.S. child support laws relative to the timing of pregnancy, from 1977 to 1992, I find that marriages following an unplanned pregnancy are less likely to occur under strengthened child support laws, accounting for about a 7-8 percentage point reduction relative to a base of 38 percent. I find that the child support rollout reduced the abortion rate by 1-2 per 1000 women aged 15-44, off a base of 28, representing about 50 percent of the total decline in the abortion rate over this period.
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Why are employer-sponsored health insurance premiums higher in the public sector than in the private sector?
February 2019
Working Paper Number:
CES-19-03
In this article, we examine the factors explaining differences in public and private sector health insurance premiums for enrollees with single coverage. We use data from the 2000 and 2014 Medical Expenditure Panel Survey-Insurance Component, along with decomposition methods, to explore the relative explanatory importance of plan features and benefit generosity, such as deductibles and other forms of cost sharing, basic employee characteristics (e.g., age, gender, and education), and unionization. While there was little difference in public and private sector premiums in 2000, by 2014, public premiums had exceeded private premiums by 14 to 19 percent. We find that differences in plan characteristics played a substantial role in explaining premium differences in 2014, but they were not the only, or even the most important, factor. Differences in worker age, gender, marital status, and educational attainment were also important factors, as was workforce unionization.
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Head Start and Mothers' Work: Free Child Care or Something More?
March 2018
Working Paper Number:
CES-18-13
Head Start is the largest public pre-school program in the US, but it provides many additional services to families. This paper uses a discontinuity in grant writing assistance in the first year of the Head Start program to identify impacts on the work and welfare usage of mothers. Using restricted Decennial Census and administrative AFDC data I find that Head Start decreases employment rates and hours worked per week for single mothers. I also find a suggestive increase in welfare receipt for single mothers which is confirmed by an increase in the share of administrative welfare case-files that are single mother households. For all mothers combined there are no significant changes in work or welfare use. I also estimate long-run impacts, 10 years after a woman's child was eligible for Head Start. I find large and persistent declines in work for both non-white mothers and single mothers, accompanied by an increase in public assistance income and return to school. I argue that this is consistent with the 1960's era Head Start program's focus on encouraging quality parenting, parent participation and helping families access all benefits for which they were eligible.
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Labor Market Effects of the Affordable Care Act: Evidence from a Tax Notch
July 2017
Working Paper Number:
carra-2017-07
States that declined to raise their Medicaid income eligibility cutoffs to 138 percent of the federal poverty level (FPL) under the Affordable Care Act (ACA) created a "coverage gap'' between their existing, often much lower Medicaid eligibility cutoffs and the FPL, the lowest level of income at which the ACA provides refundable, advanceable "premium tax credits'' to subsidize the purchase of private insurance. Lacking access to any form of subsidized health insurance, residents of those states with income in that range face a strong incentive, in the form of a large, discrete increase in post-tax income (i.e. an upward notch) at the FPL, to increase their earnings and obtain the premium tax credit. We investigate the extent to which they respond to that incentive. Using the universe of tax returns, we document excess mass, or bunching, in the income distribution surrounding this notch. Consistent with Saez (2010), we find that bunching occurs only among filers with self-employment income. Specifically, filers without children and married filers with three or fewer children exhibit significant bunching. Analysis of tax data linked to labor supply measures from the American Community Survey, however, suggests that this bunching likely reflects a change in reported income rather than a change in true labor supply. We find no evidence that wage and salary workers adjust their labor supply in response to increased availability of directly purchased health insurance.
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DOES PARENTS' ACCESS TO FAMILY PLANNING INCREASE CHILDREN'S OPPORTUNITIES? EVIDENCE FROM THE WAR ON POVERTY AND THE EARLY YEARS OF TITLE X
January 2017
Working Paper Number:
CES-17-67
This paper examines the relationship between parents' access to family planning and the economic resources of their children. Using the county-level introduction of U.S. family planning programs between 1964 and 1973, we find that children born after programs began had 2.8% higher household incomes. They were also 7% less likely to live in poverty and 12% less likely to live in households receiving public assistance. After accounting for selection, the direct effects of family planning programs on parents' incomes account for roughly two thirds of these gains.
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Local Labor Demand and Program Participation Dynamics
November 2016
Working Paper Number:
carra-2016-10
Estimates the effect of fluctuations in local labor conditions on the likelihood that existing participants are able to transition out of the Supplemental Nutrition Assistance Program (SNAP). Our primary data are SNAP administrative records from New York (2007-2012) linked to the 2010 Census at the person-level. We further augment these data by linking to industry-specific labor market indicators at the county-level. We find that local labor markets matter for the length of time individuals spend on SNAP, but there is substantial heterogeneity in estimated effects across local industries. While employment growth in industries with small shares of SNAP participants has no impact on SNAP exits, growth in local industries with creases the likelihood that recipients exit the program. We also observe corresponding increases in entries when these industries experience localized contractions. Notably, estimated industry effects vary across race groups and parental status, with Black Alone non-Hispanic, Hispanic, and mothers benefiting the least from improvements in local labor market conditions.
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Income Effects in Labor Supply: Evidence from Child-Related Tax Benefits
May 2016
Working Paper Number:
CES-16-24
A parent whose child is born in December can claim child-related tax benefits when she files her tax return a few months later. Parents of children born in January must wait more than a year before they can receive child-related tax benefits. As a result, families with December births have higher after-tax income in the first year of a child's life than otherwise similar families with January births. This paper estimates the corresponding income effect on maternal labor supply, testing whether mothers who give birth in December work and earn less in the months following birth. We use data from the American Community Survey, the Survey of Income and Program Participation, and the 2000 Decennial Census. We find that December mothers have a lower probability of working, particularly in the third month after a child's birth. Earnings data from the SIPP indicate that an additional dollar of child-related tax benefits reduces annual maternal earnings in the year following a child's birth by approximately one dollar.
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