Social and Behavioral Sciences Commons^™

Medicaid Managed Care And The Health Care Utilization Of Foster Children, Makayla Palmer, James Marton, Aaron Yelowitz, Jeffery Talbert

Economics Faculty Publications

A recent trend in state Medicaid programs is the transition of vulnerable populations into Medicaid managed care (MMC) who were initially carved out of such coverage, such as foster children or those with disabilities. The purpose of this article is to evaluate the impact of the transition of foster children from fee-for-service Medicaid coverage to MMC coverage on outpatient health care utilization. There is very little empirical evidence on the impact of managed care on the health care utilization of foster children because of the recent timing of these transitions as well as challenges associated with finding data sets large …

Early Effects Of The Affordable Care Act On Health Care Access, Risky Health Behaviors, And Self-Assessed Health, Charles J. Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata

Institute for the Study of Free Enterprise Working Papers

The goal of the Affordable Care Act (ACA) was to achieve nearly universal health insurance coverage through a combination of mandates, subsidies, marketplaces, and Medicaid expansions, most of which took effect in 2014. We use data from the Behavioral Risk Factor Surveillance System to examine the impacts of the ACA on health care access, risky health behaviors, and self-assessed health after two years. We estimate difference-in-difference-in-differences models that exploit variation in treatment intensity from state participation in the Medicaid expansion and pre-ACA uninsured rates. Results suggest that the ACA led to sizeable improvements in access to health care in both …

Consumer's Guide To Regulatory Impact Analysis: Ten Tips For Being An Informed Policymaker, Susan Dudley, Richard Belzer, Glenn C. Blomquist, Timothy Brennan, Christopher Carrigan, Joseph Cordes, Louis A. Cox, Arthur Fraas, John Graham, George Gray, James Hammitt, Kerry Krutilla, Peter Linquiti, Randall Lutter, Brian Mannix, Stuart Shapiro, Anne Smith, W. Kip Viscusi, Richard Zerbe

Economics Faculty Publications

Regulatory impact analyses (RIAs) weigh the benefits of regulations against the burdens they impose and are invaluable tools for informing decision makers.We offer 10 tips for nonspecialist policymakers and interested stakeholders who will be reading RIAs as consumers.

1. Core problem: Determine whether the RIA identifies the core problem (compelling public need) the regulation is intended to address.
2. Alternatives: Look for an objective, policy-neutral evaluation of the relative merits of reasonable alternatives.
3. Baseline: Check whether the RIA presents a reasonable “counterfactual” against which benefits and costs are measured.
4. Increments: Evaluate whether totals and averages obscure relevant distinctions and trade-offs.
5. Uncertainty: Recognize …

Second Chance For High School Dropouts? A Regression Discontinuity Analysis Of Postsecondary Educational Returns To The Ged, Christopher Jepsen, Peter Mueser, Kenneth R. Troske

Economics Faculty Publications

We evaluate the educational returns to General Educational Development (GED) certification using state administrative data. We use fuzzy regression discontinuity (FRD) methods to account for the fact that GED test-takers can repeatedly retake the test until they pass it and the fact that test-takers have to pass all five subtests before receiving the GED. We find that the GED increases the likelihood of postsecondary attendance and course completion substantially but that the GED impact on overall credits completed is modest; the GED causes an average increment of only two credits for men and six credits for women.

Unique Prediction Of Cannabis Use Severity And Behaviors By Delay Discounting And Behavioral Economic Demand, Justin C. Strickland, Joshua A. Lile, William W. Stoops

Psychology Faculty Publications

Few studies have simultaneously evaluated delay discounting and behavioral economic demand to determine their unique contribution to drug use. A recent study in cannabis users found that monetary delay discounting uniquely predicted cannabis dependence symptoms, whereas cannabis demand uniquely predicted use frequency. This study sought to replicate and extend this research by evaluating delay discounting and behavioral economic demand measures for multiple commodities and including a use quantity measure. Amazon.com’s Mechanical Turk was used to sample individuals reporting recent cannabis use (n = 64) and controls (n = 72). Participants completed measures of monetary delay discounting as well as alcohol …

The Growth Of Government, Trust In Government, And Evidence On Their Coevolution, Steven Gordon, John Garen, J. R. Clark

Institute for the Study of Free Enterprise Working Papers

The coevolution of trust in government alongside the growth of government is an aspect of the latter topic that has not been explored. Moreover, trust is viewed as part of social capital, facilitating social and economic transactions and the governance of society, and its decline has caused concern. We consider this coevolution in the context of a political economy model and a public interest view of government growth, incorporating the role of trust in government. Though a negative association of the growth in government with trust in government is broadly consistent with the historical data since the late 1950s, we …

Subcontracting And The Survival Of Plants In The Road Construction Industry: A Panel Quantile Regression Analysis, Dakshina G. De Silva, Georgia Kosmopoulou, Carlos Lamarche

Economics Faculty Publications

This paper investigates how subcontracting parts of contracted work shapes entrants’ success and survival. We find that newly developed quantile regression approaches can be adapted to study survival of firms competing for government contracts in road construction. The method is applied on a data set that includes patterns of firm entry, exit and auction related information. We find an apparent increase in the business life of firms who subcontract out part of their projects. In Texas, these subcontracting effects appear to be more pronounced for firms with few or no options outside the industry, and among firms who contract out …

Single Bidders And Tacit Collusion In Highway Procurement Auctions, David R. Barrus, Frank A. Scott Jr.

Institute for the Study of Free Enterprise Working Papers

Collusion in auctions can take different forms, one of which is refraining from bidding. Such behavior may be overt or tacit.Certain aspects of highway procurement auctions facilitate collusive outcomes. We collect data on asphalt paving auctions conducted by the Kentucky Transportation Cabinet from 2005 to 2007. We analyze both the bid participation decision and the pricing decision. We include variables that affect firm’s’ costs as well as variables that capture competitive and strategic effects. Most importantly, we determine the potential service area of each asphalt plant and use that information to determine the potential bidders for each paving project. We …

How Well Does Snap Protect Families Against The Risk Of Food Insecurity And Poor Health During Economic Downturns?, Thomas Deleire, Bradley Hardy, Jay Bhattacharya

University of Kentucky Center for Poverty Research Discussion Paper Series

Our research project addressed the question of how well SNAP and the social safety net protects families against the risk of food insecurity and poor health during economic downturns. Previous research has documented the relationship between reductions in family incomes and food insufficiency and has examined the effects of resources that mitigate the effects of income volatility. The U.S. social safety net, including SNAP, exists to mitigate the deleterious effects of swings in family income, particularly among low- and moderate-income households. This work compares outcomes for lower income families and higher income families in response to economic downturns. To the …

The Economic Impacts Of Land Use Policies In Lexington, Kentucky, Christopher R. Bollinger, William H. Hoyt, Michael W. Clark, Xiaozhou Ding

CBER Research Report

Every five years, Lexington-Fayette Urban County Government’s Planning Commission adopts a comprehensive plan detailing goals and objectives that guide the city’s land use planning. Maintaining the city’s urban service area and preserving its rural and agricultural areas are integral parts of this plan. Within the urban service area, land is zoned to permit various types of urban uses such as residential, commercial, and industrial use. Land outside the urban service area is subject to several land use policies designed to preserve the rural characteristics of these areas. This report examines the effects of Lexington’s land use policies and specifically its …

The Returns To Lobbying: Evidence From Local Governments In The "Age Of Earmarks", Steven Gordon

Institute for the Study of Free Enterprise Working Papers

The federal government transfers considerable sums to local governments in the form of intergovernmental grants. With the exception of health and welfare programs, most intergovernmental grants to local governments are classified as discretionary spending. In its annual appropriations process, Congress decides how funding for discretionary spending will be broken up among the various agencies, but more detailed decisions about specific uses of funds are left to the executive branch.

Interwar Price Level Targeting, James S. Fackler, Randall E. Parker

Institute for the Study of Free Enterprise Working Papers

Fackler and Parker argue that the Great Depression may have been preventable with a formalized policy rule proposed by economist Irving Fisher. Policymakers have an ongoing debate about whether formalized policy rules are better than discretionary policy decisions for economic outcomes. The authors’ analysis suggests that in the case of the Great Depression, if Fisher’s policy rule had been adopted in 1930 the collapse of the economy would have been avoided.

Using Natural Experiments To Identify The Effects Of Snap On Child And Adult Health, Daniel P. Miller, Taryn W. Morrissey

University of Kentucky Center for Poverty Research Discussion Paper Series

The Supplemental Nutrition Assistance Program (SNAP; formerly known as food stamps) can have important impacts that extend beyond its intended aims to improve food security and nutrition, particularly for health and health care use. This project examined the impact of SNAP receipt and benefit level on the health of adults and children using two natural experiments to address selection bias: 1) state policy variation in SNAP in an instrumental variables (IV) analysis; and, 2) the temporary expansion of SNAP benefits and eligibility provided through the American Recovery and Reinvestment Act (ARRA) in a difference-in-difference (DD) approach. We used restricted data …

Child Age And Gender Differences In Food Security In A Low-Income Inner-City Population, Robert A. Moffitt, David C. Ribar

University of Kentucky Center for Poverty Research Discussion Paper Series

A long literature in economics concerns itself with differential allocations of resources to different children within the family unit. In a study of approximately 1,500 very disadvantaged families with children in Boston, Chicago, and San Antonio from 1999 to 2005, significant differences in levels of food allocation, as measured by an indicator of food “insecurity,” are found across children of different ages and genders. Using answers to unique survey questions for a specific child in the family, food insecurity levels are found to be much higher among older boys and girls than among younger ones, and to be sometimes higher …

Kentucky Annual Economic Report 2017, Christopher R. Bollinger, William H. Hoyt, David Blackwell, Michael T. Childress

Kentucky Annual Economic Report

No abstract provided.

Impact Of Food Insecurity And Snap Participation On Healthcare Utilization And Expenditures, Seth A. Berkowitz, Hilary K. Seligman, Sanjay Basu

University of Kentucky Center for Poverty Research Discussion Paper Series

We tested three hypothesis related to food insecurity and the Supplemental Nutrition Assistance Program (SNAP), America’s largest anti-food insecurity program. We hypothesized that 1)food insecurity would be associated with increased healthcare expenditures, 2)food insecurity would be associated with increased use of emergency department and inpatient services, and 3) SNAP participation would be associated with lower subsequent healthcare expenditures. We used data from the 2011 National Health Interview Survey linked to the 2012-13 Medical Expenditures Panel Survey. We used zero-inflated negative binomial regression to test the relationship between food insecurity and healthcare cost and use. We evaluated the association between SNAP …

The Real Value Of Snap Benefits And Health Outcomes, Hilary W. Hoynes, Erin Bronchetti, Garret Christensen

University of Kentucky Center for Poverty Research Discussion Paper Series

The food stamp program (SNAP) is one of the most important elements of the social safety net and is the second largest anti-poverty program for children in the U.S. (only the EITC raises more children above poverty). The program varies little across states and over time, which creates challenges for quasi-experimental evaluation. Notably, SNAP benefit levels are fixed across 48 states; but local food prices vary widely, leading to substantial variation in the real value of SNAP benefits. In this study, we leverage time variation in the real value of the SNAP benefit across markets to examine the effects of …