The Affordable Care Act (ACA) dramatically expanded health insurance, but questions remain regarding its effects on health. We focus on older adults for whom health insurance has greater potential to improve health and well-being because of their greater health care needs relative to younger adults. We further focus on low-income adults who were the target of the Medicaid expansion. We believe our study provides the first evidence of the health-related effects of ACA Medicaid expansion using the Health and Retirement Study (HRS). Using geo-coded data from 2010 to 2016, we estimate difference-in-differences models, comparing changes in outcomes before and after the Medicaid expansion in treatment and control states among a sample of over 3,000 unique adults aged 50 to 64 with income below 100% of the federal poverty level. The HRS allows us to examine morbidity outcomes not available in administrative data, providing evidence of the mechanisms underlying emerging evidence of mortality reductions due to expanded insurance coverage among the near-elderly. We find that the Medicaid expansion was associated with a 15 percentage point increase in Medicaid coverage which was largely offset by declines in other types of insurance. We find improvements in several measures of health including a 12% reduction in metabolic syndrome; a 32% reduction in complications from metabolic syndrome; an 18% reduction in the likelihood of gross motor skills difficulties; and a 34% reduction in compromised activities of daily living (ADLs). Our results thus suggest that the Medicaid expansion led to improved physical health for low-income, older adults.
Objective
We examine whether Property Assessed Clean Energy (PACE) programs, an innovative financing mechanism using municipal bonds to finance the up‐front cost of household energy conservation projects, reduced conventional energy purchases by residential customers and increased energy generated through residential solar panel and fuel cell installations.
Methods
Using data on municipal bond issuances, electricity and natural gas purchases, and self‐generated energy, we use a difference‐in‐differences design to estimate the effect of PACE bonds issued in California between 2009 and 2017 on purchases and self‐generation.
Results
We find more residential energy self‐generation in counties with PACE programs. Results are inconclusive for conventional energy purchases, suggesting a possible rebound effect.
Conclusion
While innovative financing mechanisms facilitate access to otherwise prohibitively expensive technologies, governments must consider that behavioral responses may result in lower efficacy than desired and should consider pairing financing tools with instruments that concurrently promote reduced energy consumption.
This paper examines the impact of the 529 plan tax benefits on plan participation and savings. Using state-level data on tax benefits for plan contributions and on the number of open accounts and the amount of assets under management, we estimate fixed effects regression of the use of 529 accounts as a function of measures of tax benefit generosity. Our results imply that offering a tax benefit per se does not significantly increase the percentage of children with an account or the average balances in accounts. In addition, while regression analysis suggests that offering a larger tax benefit for a moderate contribution leads to a small increase in the growth of the percentage of children with 529 savings plans and a larger tax benefit for the maximum contribution is associated with larger balances in savings plans, neither finding is sustained within multiple permutation tests and both are likely spurious.
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