Papers Containing Keywords(s): 'medicaid'
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Viewing papers 31 through 40 of 42
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Working PaperIncome Packaging and Economic Disconnection: Do Sources of Support Differ from Other Low-Income Women?
December 2013
Working Paper Number:
CES-13-61
Income packaging, or piecing together cash and non-cash resources from a variety of sources, is a common financial survival strategy among low-income women. This strategy is particularly important for economically disconnected women, who lack both employment income and public cash assistance receipt. Using data from the confidential Census Bureau versions of the Survey of Income and Program Participation, this study compares the use of public and private supports between disconnected and connected low-income women, controlling for differences in state welfare rules and county unemployment rates. Findings from bivariate comparisons and multilevel logistic regressions indicate that disconnected women utilize public non-cash supports at similar rates to connected women, but rely more heavily on private sources. Conclusions focus on the policy implications for outreach and program development.View Full Paper PDF
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Working PaperCOMPARING METHODS FOR IMPUTING EMPLOYER HEALTH INSURANCE CONTRIBUTIONS IN THE CURRENT POPULATION SURVEY
August 2013
Working Paper Number:
CES-13-41
The degree to which firms contribute to the payment of workers' health insurance premiums is an important consideration in the measurement of income and for understanding the potential impact of the 2010 Affordable Care Act on employment-based health insurance participation. Currently the U.S. Census Bureau imputes employer contributions in the Annual Social and Economic Supplement of the Current Population Survey based on data from the 1977 National Medical Care Expenditure Survey. The goal of this paper is to assess the extent to which this imputation methodology produces estimates reflective of the current distribution of employer contributions. The paper uses recent contributions data from the Medical Expenditure Panel Survey-Insurance Component to estimate a new model to inform the imputation procedure and to compare the resulting distribution of contributions. These new estimates are compared with those produced under current production methods across employee and employer characteristics.View Full Paper PDF
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Working PaperAn Analysis of Sample Selection and the Reliability of Using Short-term Earnings Averages in SIPP-SSA Matched Data
December 2011
Working Paper Number:
CES-11-39
In this paper, we document the extent to which the sample of the Survey of Income and Program Participation that is matched to the Social Security Administration's administrative earnings records is nationally representative. We conclude that the match bias is small, so selection is not a serious concern. The matched sample over-represents individuals who are wealthy, who have financial assets or who have received a government-transfer and under-represents individuals who attrited from the SIPP. We use this matched sample to examine the relationship between short-term averages of earnings from the SIPP earnings and average lifetime earnings from the administrative records. Our estimates suggest that using short averages of earnings may understate the effects of permanent income on particular outcomes of interest.View Full Paper PDF
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Working PaperLong-Run Earnings Volatility and Health Insurance Coverage: Evidence from the SIPP Gold Standard File
October 2011
Working Paper Number:
CES-11-35
Despite the notable increase in earnings volatility and the attention paid to the growing ranks of the uninsured, the relationship between career earnings and short- and mediumrun health insurance status has been ignored due to a lack of data. I use a new dataset, the SIPP Gold Standard File, that merges health insurance status and demographics from the Survey of Income and Program Participation with career earnings records from the Social Security Administration (SSA) and the Internal Revenue Service (IRS) to examine the relationship between long-run family earnings volatility and health insurance coverage. I find that more volatile career earnings are associated with an increased probability of experiencing an uninsured episode, with larger effects for men, young workers, and the unmarried. These findings are consistent with the 'scarring' literature, and suggest the importance of safety-net measures for job losses and health insurance coverage.View Full Paper PDF
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Working PaperDeclines in Employer Sponsored Coverage Between 2000 and 2008: Offers, Take-Up, Premium Contributions, and Dependent Options
September 2010
Working Paper Number:
CES-10-23
Even before the current economic downturn, rates of employer-sponsored insurance (ESI) declined substantially, falling six percentage points between 2000 and 2008 for nonelderly Americans. During a previously documented decline in ESI, from 1987 to 1996, the fall was found to be the result of a reduction in enrollment or 'take-up' of offered coverage and not a decline in employer offer/eligibility rates. In this paper, we investigate the components of the more recent decline in ESI coverage by firm size, using data from the MEPS-IC, a large nationally representative survey of employers. We examine changes in offer rates, eligibility rates and take-up rates for coverage, and include a new dimension, the availability of and enrollment in dependent coverage. We investigate how these components changed for employers of different sizes and find that declining coverage rates for small firms were due to declines in both offer and take-up rates while declining rates for large firms were due to declining enrollment in offered coverage. We also find a decrease in the availability of dependent coverage at small employers and a shift towards single coverage across employers of all sizes. Understanding the components of the decline in coverage for small and large firms is important for establishing the baseline for observing the effects of the current economic downturn and the implementation of health insurance reform.View Full Paper PDF
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Working PaperHealth Insurance and Productivity: Evidence from the Manufacturing Sector
September 2009
Working Paper Number:
CES-09-27
This paper examines the relationship between employer-sponsored offers of health insurance and establishments' labor productivity. Our empirical work is based on unique plant level data that links the 1997 and 2002 Medical Expenditure Panel Survey-Insurance Component with the 1992, 1997, and 2002 Census of Manufactures. These linked data provide information on employer-provided insurance and productivity. We find that health insurance offers are positively associated with levels of establishments' labor productivity. These findings hold for all manufacturers as well as those with fewer than 100 employees. Our preliminary results also show a drop in health care costs from the 75th to the 25th percentile would increase the probability of a plant offering insurance by 1.5-2.0 percent in both 1997 and 2002. The results from this paper provide encouraging and new empirical evidence on the benefits employers may reap by offering health insurance to workers.View Full Paper PDF
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Working PaperComplex Survey Questions and the Impact of Enumeration Procedures: Census/American Community Survey Disability Questions
April 2009
Working Paper Number:
CES-09-10
This paper explores challenges relating to the identification of the population with disabilities,focusing on Census Bureau efforts using the 2000 Decennial Census Long-Form (Census 2000) and 2000-2005 American Community Survey (ACS). In particular, the analyses explore the impact of survey methods on responses to the work limitation (i.e., employment disability) question in these two Census products. Building on the research of Stern (2003) and Stern and Brault (2005), we look for further evidence of misreporting of an employment disability by specific sub-populations using the participation in the Supplemental Security Income program as an exogenous employment disability status indicator along with a subset of ACS disability questions. We expand upon these earlier studies by examining both false-positive and falsenegative reports of employment disability by implementing logit estimations to examine the role of respondent/enumerator error on the accuracy of the employment disability response. In this manner, we enhance our understanding of Census 2000 and ACS responses to employment disability questions through an exploration of the role of enumeration procedures in two types of misclassifications, as well as by evaluating existing data and estimates to uncover characteristics that might make an individual more likely to misreport an employment disability.View Full Paper PDF
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Working PaperHealth-Related Research Using Confidential U.S. Census Bureau Data
August 2008
Working Paper Number:
CES-08-21
Economic studies on health-related issues have the potential to benefit all Americans. The approaches for dealing with the growth of health care costs and health insurance coverage are ever changing and information is needed on their efficacy. Research on health-related topics has been conducted for about a decade at the Census Bureau\u2019s Center for Economic Studies and the Research Data Centers. This paper begins by describing the confidential business and demographic Census Bureau data products used in this research. The discussion continues with summaries of nearly 30 papers, including how this work has benefited the Census Bureau and its research findings. Some focus on data linkages and assessing data quality, while others address important questions in the employer, public, and individual insurance markets. This research could not have been accomplished with public-use data. The newly available data from the Agency for Healthcare Research and Quality and National Center for Health Statistics, as well as additional Census Bureau data now available in the Research Data Centers are also discussed.View Full Paper PDF
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Working PaperManufacturing Firms' Decisions Regarding Retiree Health Insurance
June 2003
Working Paper Number:
CES-03-14
This study analyzes the firm's decision to offer and contribute to retiree health insurance. We apply a binomial probit model and an interval regression model to analyze the likelihood of offering and the proportion of costs contributed by the firm. Our findings indicate that while firm characteristics affect the probability that a firm offers retiree health insurance, financial performance and alternative insurance options significantly affect the firm's generosity towards its cost. This study expands on previous research by including potentially important policy-related measures to the more limited set of firm and workforce characteristics that have been typically employed.View Full Paper PDF
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Working PaperThe Measurement of Medicaid Coverage in the SIPP: Evidence from California, 1990-1996
September 2002
Working Paper Number:
CES-02-21
This paper studies the accuracy of reported Medicaid coverage in the Survey of Income and Program Participation (SIPP) using a unique data set formed by matching SIPP survey responses to administrative records from the State of California. Overall, we estimate that the SIPP underestimates Medicaid coverage in the California populaton by about 10 percent. Among SIPP respondents who can be matched to administrative records, we estimate that the probability someone reports Medicaid coverage in a month when they are actually covered is around 85 percent. The corresponding probability for low-income children is even higher ' at least 90 percent. These estimates suggest that the SIPP provides reasonably accurate coverage reports for those who are actually in the Medicaid system. On the other hand, our estimate of the false positive rate (the rate of reported coverage for those who are not covered in the administrative records) is relatively high: 2.5 percent for the sample as a whole, and up to 20 percent for poor children. Some of this is due to errors in the recording of Social Security numbers in the administrative system, rather than to problems in the SIPP.View Full Paper PDF
