Including Health Insurance in Poverty Measurement: The Impact of Massachusetts Health Reform on Poverty
We develop and implement what we believe is the first conceptually valid health-inclusive poverty measure (HIPM)—a measure that includes health care or insurance in the poverty needs threshold and health insurance benefits in family resources—and we discuss its limitations. Building on the Census Bureau’s Supplemental Poverty Measure, we construct a pilot HIPM for the under-65 population under ACA-like health reform in Massachusetts. This pilot is intended to demonstrate the practicality, face validity and value of a HIPM. Results suggest that public health insurance benefits and premium subsidies accounted for a substantial, one-third reduction in the poverty rate. Among low-income families who purchased individual insurance, premium subsidies reduced poverty by 9.4 percentage points.
We thank Rob Patrizzo for excellent research assistance, supported by a Baruch College School of Public Affairs Graduate Assistantship. We thank Jonathan Gruber, Michael Norton of the Massachusetts Health Connector and Keith Ericsson for assistance obtaining the Massachusetts health plan data used in this paper. We thank Neil Bennett, Rebecca Blank, Richard Burkhauser, Irv Garfinkel, Thesia Garner, Diane Gibson, David Johnson, Sherry Glied, Mark Levitan, Brendan Saloner, and discussants and participants at the 2014 APPAM, 2014 ASHEcon and 2015 PAA conferences for comments on earlier drafts and useful discussions. All errors are our own. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.
Sanders Korenman & Dahlia K. Remler, 2016. "Including health insurance in poverty measurement: The impact of massachusetts health reform on poverty," Journal of Health Economics, .