NBER Working Papers and Publications
|July 2013||Do Insurers Risk-Select Against Each Other? Evidence from Medicaid and Implications for Health Reform|
with Ilyana Kuziemko, Maya Rossin-Slater: w19198
Increasingly in U.S. public insurance programs, the state finances and regulates competing, capitated private health plans but does not itself directly insure beneficiaries through a public fee-for-service (FFS) plan. We develop a simple model of risk-selection in such settings. Capitation incentivizes insurers to retain low-cost clients and thus improve their care relative to high-cost clients, who they prefer would switch to a competitor. We test this prediction using county transitions from FFS Medicaid to capitated Medicaid managed care (MMC) for pregnant women and infants. We first document the large health disparities and corresponding cost differences between blacks and Hispanics (who make up the large majority of Medicaid enrollees in our data), with black births costing nearly...
|March 2013||Something in the Water: Contaminated Drinking Water and Infant Health|
with Janet Currie, Joshua S. Graff Zivin, Matthew J. Neidell, Wolfram Schlenker: w18876
This paper provides estimates of the effects of in utero exposure to contaminated drinking water on fetal health. We examine the universe of birth records and drinking water testing results for the state of New Jersey from 1997 to 2007. Our data enable us to compare outcomes across siblings who were potentially exposed to differing levels of harmful contaminants from drinking water while in utero. We find small effects of drinking water contamination on all children, but large and statistically significant effects on birth weight and gestation of infants born to less educated mothers. We also show that those mothers who were most affected by contaminants were the least likely to move between births in response to contamination.
Published: Janet Currie & Joshua Graff Zivin & Katherine Meckel & Matthew Neidell & Wolfram Schlenker, 2013. "Something in the water: contaminated drinking water and infant health," Canadian Journal of Economics/Revue canadienne d'économique, vol 46(3), pages 791-810. citation courtesy of