Spousal Insurance Research Articles

Wage Risk and Government and Spousal Insurance

Abstract The extent to which households can self-insure depends on family structure and wage risk. We calibrate a model of couples and singles’ savings and labour supply under two types of wage processes. The first wage process is the canonical—age-independent, linear—one that is typically used to evaluate government insurance provision. The second wage process is a flexible one. We use our model to evaluate the optimal mix of the two most common types of means-tested benefits—IW versus income floor. The canonical wage process underestimates wage persistence for women and thus implies that IW benefits should account for most benefit income. In contrast, the richer wage process that matches the wage data well, implies that the income floor should be the main benefit source, similarly to the system in place in the U.K. This stresses that allowing for rich wage dynamics is important to properly evaluate policy.

Health insurance coverage and marriage behavior: Is there evidence of marriage lock?

AbstractPremiums and eligibility for health insurance may cause a “marriage lock,” in which couples stay married for the sake of maintaining health insurance coverage. By using the Health and Retirement Study for adults aged 60–70, I examine whether employer‐based health insurance coverage for the spouse discourages divorce for spousal health insurance coverage‐dependent individuals. Diverse difference‐in‐difference models provide evidence of a 7 percentage points increase in the number of divorces upon achieving Medicare eligibility at age 65 for people with spousal insurance coverage relative to those without it. The estimates thus provide evidence that marriage lock exists.

The effect of the Affordable Care Act Medicaid expansion on marriage

AbstractThis paper investigates the impact of the Affordable Care Act Medicaid expansions on marital behavior. We use data from the American Community Survey from 2008 to 2019 and estimate difference‐in‐differences models to test for effects on marriage and divorce outcomes. We find that expansions led to a 0.95% reduction in marriage stock and a 2.22% increase in divorce stock, with effects being larger among low educated individuals. We believe that two factors play a role as underlying mechanisms: (1) reduced reliance on spousal insurance coverage and (2) deciding to forego marriage or get divorced to meet eligibility restrictions.

Spousal Insurance, Outside Options and Wage Bargaining

Spousal insurance raises a worker's outside option, allowing workers to bargain a higher wage. To study this mechanism I propose a random search model with ex-ante heterogeneity in ability, endogenous marriage, endogenous labor supply of spouses and wages determined by Nash Bargaining. Using the model, I derive an empirical specification to test the mechanism and the sources of endogeneity to be addressed. I use a combination of an instrument derived from theory and one instrument based on policy variation to confirm the predictions of the model. A 1 percentage point increase in the share of married women working increases the wage of married individuals by 2.51-3.51%.

Wage Risk and Government and Spousal Insurance

Wage Risk and Government and Spousal Insurance

The effect of the Affordable Care Act preexisting conditions provision on marriage.

This paper investigates the effect of the Affordable Care Act preexisting conditions provision on marriage. The policy was implemented to prevent insurers from denying insurance coverage to individuals with preexisting health conditions. We test whether the implementation of the provision led to decreases in marriage among affected adults. We add to earlier work on how marital behavior is influenced by spousal health insurance and examine for the presence of "marriage lock," a situation in which individuals remain married primarily for insurance. Using longitudinal data from the Panel Study of Income Dynamics from 2009 to 2017 and estimating difference-in-differences models, we find that male household heads with preexisting conditions are 7.12 percentage points (8.9 percent) less likely to be married after the policy. Using information on insurance status prior to the policy change, we find significant reductions in marriage among individuals with preexisting conditions who were previously insured by spousal health insurance plans. The findings suggest that the inability to attain individual coverage and reliance on spousal insurance provided incentives to remain married before 2014.

Household Labor Search, Spousal Insurance, and Health Care Reform

Health insurance in the United States for the working age population has traditionally been provided in the form of employer-sponsored health insurance (ESHI). If employers offered ESHI to their employees, they also typically extended coverage to their spouse and dependents. Provisions in the Affordable Care Act (ACA) significantly alter the incentive for firms to offer insurance to the spouses of employees. We evaluate the long-run impact of ACA on firms’ insurance offerings and on household outcomes by developing and estimating an equilibrium job search model in which multiple household members are searching for jobs. The distribution of job offers is determined endogenously, with compensation packages consisting of a wage and menu of insurance offerings (premiums and coverage) that workers select from. Using our estimated model we find that households’ valuation of employer-sponsored spousal health insurance is significantly reduced under ACA, and with an “employee-only” health insurance contract emerging among low productivity firms. We relate these outcomes to the specific provisions in the ACA.

Household Labor Search, Spousal Insurance, and Health Care Reform

Health insurance in the United States for the working age population has traditionally been provided in the form of employer-sponsored health insurance (ESHI). If employers offered ESHI to their employees, they also typically extended coverage to their spouse and dependents. Provisions in the Affordable Care Act (ACA) significantly alter the incentive for firms to offer insurance to the spouses of employees. We evaluate the long-run impact of ACA on firms’ insurance offerings and on household outcomes by developing and estimating an equilibrium job search model in which multiple household members are searching for jobs. The distribution of job offers is determined endogenously, with compensation packages consisting of a wage and menu of insurance offerings (premiums and coverage) that workers select from. Using our estimated model we find that households’ valuation of employer-sponsored spousal health insurance is significantly reduced under ACA, and with an “employee-only” health insurance contract emerging among low productivity firms. We relate these outcomes to the specific provisions in the ACA. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

Cyclicality of Hours Worked by Married Women and Spousal Insurance

I document that married women's hours worked are significantly less cyclical than hours worked by married men and singles and argue that spousal insurance contributes to the low cyclicality. Analyzing volatility, transition rates, and household behavior, I show that (i) married women experience the lowest cyclical volatility; (ii) their volatility depends more on pastthan current fluctuations of business cycle indicators; (iii) married women are less likely to become unemployed or leave the labor force during recessions, but not more likely to join the laborforce; and (iv) unemployment of the husband is associated with more hours worked by the wife, particularly during recessions.

LGBT Psychiatric Leaders Reflect on Landmark Supreme Court Ruling

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The Effect of Medicare Eligibility on Spousal Insurance Coverage.

A majority of married couples in the USA take advantage of the fact that employers often provide health insurance coverage to spouses. When older spouses become eligible for Medicare, however, many of them can no longer provide their younger spouses with coverage. In this paper, we study how spousal eligibility for Medicare affects the health insurance and health care access of younger spouses. We find that spousal eligibility for Medicare results in younger spouses no longer having employers pay for their insurance and being less likely to have employer-sponsored coverage. Instead, younger spouses switch to privately purchased coverage, which tends to be worse than what they had before their spouses became eligible for Medicare. We also find suggestive evidence that younger spouses are less likely to use health care services after their older spouses become eligible for Medicare.

The Effect of Medicare Eligibility on Spousal Insurance Coverage

A majority of married couples in the United States take advantage of the fact that employers often provide health insurance coverage to spouses. When the older spouses become eligible for Medicare, however, many of them can no longer provide their younger spouses with coverage. In this paper, we study how spousal eligibility for Medicare affects the health insurance and health care access of the younger spouse. We find spousal eligibility for Medicare results in the younger spouse having worse insurance coverage and reduced access to health care services.

Cumulative Inequality and Racial Disparities in Health: Private Insurance Coverage and Black/White Differences in Functional Limitations

To test different forms of private insurance coverage as mediators for racial disparities in onset, persistent level, and acceleration of functional limitations among Medicare age-eligible Americans. Data come from 7 waves of the Health and Retirement Study (1996-2008). Onset and progression latent growth models were used to estimate racial differences in onset, level, and growth of functional limitations among a sample of 5,755 people aged 65 and older in 1996. Employer-provided insurance, spousal insurance, and market insurance were next added to the model to test how differences in private insurance mediated the racial gap in physical limitations. In baseline models, African Americans had larger persistent level of limitations over time. Although employer-provided, spousal provided, and market insurances were directly associated with lower persistent levels of limitation, only differences in market insurance accounted for the racial disparities in persistent level of limitations. Results suggest private insurance is important for reducing functional limitations, but market insurance is an important mediator of the persistently larger level of limitations observed among African Americans.

Married Women’s Labor Supply and Spousal Health Insurance Coverage in the United States: Results from Panel Data

This paper investigates the effect of spousal insurance coverage on married women’s labor supply. This effect was hypothesized to be negative, since married women have an incentive to seek employment in jobs that will provide insurance when their husbands do not provide coverage. Panel data from the 1996–2004 Medical Expenditure Panel Surveys was used to control for the potential correlation between unobserved characteristics and spousal insurance. The findings suggest that spousal coverage does have a negative effect on married women’s labor supply, and that most of the reduction in labor supply seems to derive from shifts out of the labor force rather than between part-time and full-time work.

The near-elderly, early retirees, and managed care.

Trends Health AffairsVol. 20, No. 6: Chronic Care In America TRENDSThe Near-Elderly, Early Retirees, And Managed CareMichael A. Morrisey and Gail A. JensenPUBLISHED:November/December 2001No Accesshttps://doi.org/10.1377/hlthaff.20.6.197AboutSectionsView articleView Full TextView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions View articleTOPICSManaged carePremiumsFee-for-serviceHealth maintenance organizationsMedicare eligibilityMedicarePreferred provider organizationsDisabilitiesPrivate health insuranceManaged care plans Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article MetricsCitations: Crossref 10 History Published online 1 November 2001 InformationCopyright 2001 by Project HOPE - The People-to-People Health Foundation, Inc.PDF downloadCited byImpact of the supplemental nutritional assistance program on diet‐related disease morbidity among older adults24 January 2021 | Health Services Research, Vol. 56, No. 5The Effect of Medicare Eligibility on Spousal Insurance Coverage11 March 2015 | Health Economics, Vol. 25, No. 5The Effect of Medicare Eligibility on Spousal Insurance CoverageSSRN Electronic JournalInsurance Disruption due to Spousal Medicare Transitions: Implications for Access to Care and Health Care Utilization for Women Approaching Age 65Health Services Research, Vol. 44, No. 3China, Beware: What American Health Care Has to Learn from SingaporeManaged care and the near-elderly: effects of plan enrollment on functionalityApplied Economics, Vol. 39, No. 16Health Effects of Managed Care Among the Near-Elderly30 June 2016 | Journal of Aging and Health, Vol. 18, No. 4Insurance coverage and health care use among near-elderly womenWomen's Health Issues, Vol. 16, No. 3Are Healthier Older Adults Choosing Managed Care?The Gerontologist, Vol. 44, No. 1Trends In Retiree Health BenefitsLauren A. McCormack, Jon R. Gabel, Heidi Whitmore, Wayne L. Anderson, and Jeremy Pickreign17 August 2017 | Health Affairs, Vol. 21, No. 6