Interrelationships among public spending preferences: A micro analysis

This paper examines a system of qualitative demand equations for public spending on education, welfare, housing, health, highways, and defense. The demand for public spending for a particular category is hypothesized to be a function of income, tax-price, private benefit measures, and tastes as well as demands for other public expenditure categories. Based on individual survey data, the conditional maximum likelihood estimates of the logit equations are obtained. The results indicate the significant role of tastes, private benefit variables, and tax-prices. In addition, positive rather than negative, demand interrelationships are found to exist. These findings question the validity of the median voter hypothesis as a model for public budget allocation.     

收入、健康与医疗保险对老年人幸福感的影响

本文使用中国9个省、2200名55岁以上老年人的微观调查数据,主要检验了收入水平、健康状况与医疗保险对主观幸福感的影响。Ordered Logit回归分析结果表明：收入增加能够显著提高城镇老年人的主观幸福感,收入差距的影响不显著;对农村老年人而言,收入的作用不明显,而收入差距则有显著的负向影响。心理健康和城乡老年人幸福感呈高度的正相关,记忆力、日常生活自理能力等身体健康因素也具有显著的正向影响。公费医疗显著提高农村老年人的幸福感,城镇职工医疗保险和合作医疗分别对城镇和农村老年人幸福感具有积极的作用。总体上,城镇老年人的主观幸福感高于农村,东部老年人幸福感高于中部,中部高于西部。因此,增加老年人的收入水平,完善老年人医疗保险制度,并逐步协调城乡和地区经济发展,有助于从整体上提高老年人的幸福感。     

Medicaid participation among the eligible elderly

This study uses data from the Survey of Income and Program Participation to address three issues: (1) what were the 1987 rates of Medicaid participation and private insurance coverage among elderly predicted to be categorically eligible and medically needy?; (2) how did these rates change between 1987 and 1992?; and (3) which factors influence insurance choices among persons who are categorically eligible for Medicaid? The 1987 Medicaid participation rates were 64 percent for the categorically eligible, but only 11 percent among the medically needy. Participation among the categorically eligible declined to 59 percent by 1992, but the difference was insignificant. In both years, about 23 percent of all categorically eligible persons had private insurance, but among those who do not participate in Medicaid, the rate rises to 48 percent.     

Child Support and the Affordable Care Act's Medicaid Expansions

A quickly developing literature has shown that the Affordable Care Act's (ACA) Medicaid expansions have improved health insurance coverage, health, and financial well‐being among low‐income adults without dependent children. This population includes noncustodial parents. With substantial overlap in the population that is typically obligated to pay child support and the population that has strongly benefited from the expansions, there may be potential implications for child support enforcement. In this paper, I examine the effect of public health insurance eligibility to low‐income adults on child support outcomes. I find that the ACA Medicaid expansions increased child support distributed to custodial families as arrears by 8.5 percent. Evidence also suggests current support distributions increased by about 2 percent. There were no significant effects on paying toward a child support order. Among unmarried mothers, the likelihood of child support receipt increased by 8 percent. These results imply that access to public health insurance can increase the ability of noncustodial parents to pay child support.     

Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply

We examined the effect of the expansion of Medicaid eligibility under the Affordable Care Act on health insurance coverage and labor supply of low‐educated and low‐income adults. We found that the Medicaid expansions were associated with large increases in Medicaid coverage, for example, 50 percent among childless adults, and corresponding decreases in the proportion uninsured. There was relatively little change in private insurance coverage, although the expansions tended to decrease such coverage slightly. In terms of labor supply, estimates indicated that the Medicaid expansions had little effect on work effort despite the substantial changes in health insurance coverage. Most estimates suggested that the expansions increased work effort, although not significantly.     

多类别养老保险对居民家庭消费影响的对比研究

在老龄化不断加深、居民消费率增长缓慢、消费需求日益多元化的背景下,研究不同类别养老保险对居民家庭消费水平和消费结构的影响日益重要。采用CGSS(2015)调查数据,使用倾向值匹配(PSM)回归模型,分析不同类别养老保险对居民家庭消费水平和消费结构的影响及内在机制,研究发现:参加基本养老保险和商业性养老保险均会显著增加居民家庭总消费、生存性消费和发展性消费,基本养老保险和商业性养老保险对发展性消费的增加效应均大于生存性消费;参加商业性养老保险对居民家庭总消费、生存性消费和发展性消费的增加效应大于基本养老保险;养老保险影响居民家庭消费的核心机制是居民的总收入以及再分配偏好。为拉动居民消费,应把第三支柱的个人养老金缴费纳入个人所得税专项或专项附加扣除;提高基础养老金的水平,进一步落实养老金水平的动态调整机制。     

Public Health Insurance and Medical Spending: The Incidence of the ACA Medicaid Expansion

This paper examines the incidence of the cost burden associated with expanding public health insurance to low-income adults in the context of the Affordable Care Act. Using data from the Medical Expenditures Panel Survey (MEPS), I exploit exogenous variation in Medicaid eligibility rules across states, income groups and time. I find that public insurance eligibility reduced mean out-of-pocket spending by 19.6 percent among targeted households, but it did not causally increase total expenditures among beneficiaries. Rather, Medicaid expansion shifted the burden of payment from eligible households and private insurance (21.5 percent reduction) to taxpayers in the form of public insurance (46.6 percent increase). The efficiency of these public funds can be summarized by a mean Marginal Value of Public Funds of 0.70 in the full sample, 0.99 among households with at least one pre-existing condition, and 1.26 in states with an above-median number of public hospitals.     

Food security and access to healthy foods in Indian country: Learning from the Food Distribution Program on Indian Reservations

Food access, food security, and nutrition‐related health disparities have long been recognized as particular challenges for Native Americans living on tribal land. The U.S. Department of Agriculture (USDA) provides nutrition assistance to tribal communities through the Food Distribution Program on Indian Reservations (FDPIR). In 2016, we completed a study of the FDPIR program for USDA's Food and Nutrition Service. This was the first national update since 1990. We found that FDPIR continued to serve people of all ages. However, since 1990, participation by children decreased whereas participation by elders increased. Consistent with the 1990 study, we found that FDPIR households are a very low‐income population. Households reported significantly higher rates of food insecurity than national averages—34% experienced low food security, and about 22% experienced very low food security. Changing demographics call for continued attention to the diverse nutritional needs of young and elderly program participants in tribal communities. Although barriers to food access persist in Indian country, FDPIR and locally sourced food initiatives help to meet needs. Nutrition and wellness education addresses health disparities and fosters healthy lifestyles. Partnerships operating at multiple levels support food production and distribution, improve access to healthy foods, and encourage healthy diets. From a policy and practice perspective, the study findings offer insights for tribal communities and rural areas that have limited access to healthy food options and illustrate how nutrition assistance programs can coexist with local initiatives to provide practical approaches to ensure healthy and adequate nutritional support.     

Health insurance in a democracy: Why is it public and why are premiums income related?

Many democracies have public health insurance systems which combine redistribution from the rich to the poor and from the healthy to the sick. This paper shows that such systems can be in the interest of the poor and the rich from a constitutional perspective. Necessary conditions are that insurance markets are incomplete and that income inequality is neither too low nor too high. Then even the rich can prefer a public health insurance system financed by income-dependent contributions compared to a system financed by a flat fee or a private health insurance system.     

Impacting the Political Landscape: Who Registers and Votes Among Naturalized Americans?

Little is known about the voting behavior of naturalized Americans, primarily due to a lack of good quality data on the national level. Using data from the Voting and Registration Supplement to the November 1996 Current Population Survey (CPS), we examine whether region of origin and length of time spent in the United States affect the likelihood of registering and voting among naturalized citizens, net of other socioeconomic and demographic factors already known to influence electoral behavior. We find that naturalized citizens who have a longer length of time at current residence and in the United States, and those who are older, with more education and higher income are more likely to register and vote. Region of origin is not a major explanatory variable, but there are differences in registering and voting by country of origin among naturalized citizens from Asia and Latin America. Finally, being registered is a necessary but not sufficient condition that predicts voting among naturalized citizens from Asia and from Latin America.     

The reverse mortgage as an asset management tool

Abstract

Reverse mortgages are usually seen as a vehicle for increasing the income of poor, elderly households. This perspective, coupled with the relatively slow growth of reverse mortgage programs, has led some observers to question the growth potential of the reverse mortgage market. This article presents a more expansive view of reverse mortgages as a financial tool for tapping housing equity for various purposes and at various stages in the life cycle.

Three market segments for reverse mortgages are discussed: elderly persons living alone, other elderly households, and non‐elderly households. Potential uses include turning housing equity into personal human capital investment accounts, enabling children to provide care for their disabled parents, funding elderly households’ long‐term care insurance, and sustaining consumption. Recent progress in product development and availability and political pressures to find private financing for health and long‐term care suggest that the reverse mortgage market has considerable growth potential.     

Cyber insurance and private governance: The enforcement power of markets

In the last half decade, cyber insurance has emerged as a multi-billion-dollar industry with the authority to set and enforce standards of security behavior. Although cybersecurity has become a concern of national policymakers, insurers appear to have supplanted the state to play an influential role in governing some aspects of client behavior. This paper explores private governance by cyber insurance firms and evaluates two competing explanations for its emergence – either that the private sector advanced to set and enforce cybersecurity standards for financial gain, or that the state retreated from its responsibility to regulate and private sector actors filled the gap only as necessary. To find an answer between these explanations, this article develops a single outcome case study of the American cyber insurance industry. Following a theoretical introduction to private governance and its manifestation through insurance, the article examines the insurance process and its application in cybersecurity, the key role of standards, and the mechanism of enforcing those standards. The article concludes by identifying key elements of this market-based enforcement and discussing implications for crafting effective private governance in other domains and public policy.     

Federalism and suitable housing for the frail elderly: A comparison of policies in Canada and the United States

Abstract

The frail elderly have special multidimensional housing needs beyond affordability, including shelter that is more adaptive to reduced function and offers supportive services. Suitable housing for this population comprises three policy areas—housing, health care, and social services. In a federal system, development and implementation of policies in these areas involves participation of several levels of government and the nongovernmental sector. This paper uses federalism as a conceptual framework to examine and compare these policy areas in Canada and the United States.

In both countries, general national housing policies—relying heavily on the nongovernmental sector and characterized by joint federal‐provincial programs in Canada and by important local government roles and age‐specific programs in the United States‐have benefited the elderly. The effects of such policies on the frail elderly, however, have been less positive because of the general lack of essential human services and, to a lesser degree, health care that enables them to live outside institutions. This is especially true in the United States, where health care policy is fragmented and is dominated by a private insurance system, partial federal financing of health insurance for the elderly, and tense federal‐state relations in financing health care for the poor. Although Canadian policies and programs operate autonomously and more uniformly within a national health plan, neither country has a universal, comprehensive long‐term care system. Geographically diverse patterns of social services, funded by grants to states and provinces and the nonprofit sector, are common to both countries. However, the United States has inadequately funded age‐specific programs and has relied on a growing commercial service provision. Housing outcomes for frail elders are moving in the right direction in both countries; however, Canada seems to be better positioned, largely because of its health care system. As increased decentralization continues to characterize the three policy areas that affect suitable housing for frail elders, the United States can learn from Canada's negotiated federalism approach to more uniform solutions to merging housing and long‐term care.     

Achievements and challenges of energy poverty alleviation policies: Evidence from the select states in India

Indian energy sector has undergone a tremendous transformation with consistent government policy interventions since 2000. Against this backdrop, we examine the extent to which energy poverty has decreased due to the expansion of energy services and the significant determinants of energy poverty in select six states in India. Overall, results reveal that absolute multidimensional energy poverty has substantially decreased across all states examined in the study as well as across all income and social groups between 2015 and 2018. Specifically, acute multidimensional energy poverty has reduced by an average of 30% between 2015 and 2018 in six states. At the same time, dependency on biomass remains more or less the same between 2015 and 2018. Results also show that inequality in the access to energy across income and social groups exists, and education is negatively related to energy poverty. Energy poverty has declined by a similar percentage among most employment groups, except for people practicing cattle rearing. Finally, culture is a significant determinant of energy poverty as households with the elderly and more land owned have higher energy poverty, probably due to the easy access to biomass and preference of such households to use it.     

Continuities in Providing for Old Age: Cross-national and Cross-cultural Comparisons

Drawing on a purposive sample of 25 interviews supplemented by secondary source material, this comparative study explores the options available to elderly immigrants in two quite similar countries to achieve social security in their old age. The focus is the culturally determined perspectives and practices of aging Italian-born and Indian-born immigrants in the context of public and private sector social welfare policies and provisions in Australia and Canada. Government transfers, occupational superannuation, tax-deductible personal savings, housing, and formal and informal supports are discussed. What is important to the sense of social security of the older people and how well-off or disadvantaged they seem to be are among the questions raised. The design affords an opportunity to test the complex combination of cross-national and cross-cultural comparison. In the certainty that the income deficiencies of today's elderly immigrants cannot be remedied easily or quickly enough to benefit those affected, intervention strategies can be aimed at expanding ethno-specific community supports and quality residential care; such a direction is supported by assessment of service availability in relation to estimates of aging among particular foreign-born immigrant groups. Suggestions are made for future research at the levels of theory and application.     

The effect of health on retirement

Results from retirement research suggest the following conclusions about health, retirement, and the likely effects of the changes in retirement age made by the 1983 Social Security Amendments. First, after controlling for non-health-related factors, it is clear that older workers who are in poor health retire earlier than workers with similar economic circumstances who are in good health. Second, the research reviewed here tends to indicate that the response of the average worker to the changes made in the social security full retirement age by the 1983 amendments will be small. Estimates suggest than the average increase in the retirement age will be between zero and 3 months. Finally, while the evidence is much less certain, research results suggest that older workers in poor health may respond even less than the average worker. It is not possible to say precisely what will happen to lifetime incomes as a result of these changes. A small labor supply response suggests that not much of the lost social security benefits will be made up by additional earnings, either for workers on average or for workers in poor health. However, earnings are only part of the total income picture. Other than a brief mention, this article has not addressed how workers may adjust their savings behavior, or how private pensions may adjust, and particularly whether the potential for adjustment through these avenues is the same for workers in poor health as for the average worker.     

An Investigation of the Public Deficts and Government Spending Relationship: Evidence for Greece

This paper tests the validity of the Buchanan-Wagner hypothesis for Greece, that increases in public spending are the result of the tolerance of large deficits over the period 1961–1994. To test this hypothesis, three unit-root pretests, the Dickey-Fuller, Phillips-Perron and Kwiatkowski et al. and maximum likelihood estimation techniques of cointegrating vectors and a vector error-correction model are employed. A long-run relationship is found to exist among government spending, deficit, income,wages and adult population and the importance of short-run deviations are presented. The empirical evidence suggests that Buchanan and Wagner hypothesis, seems to find support for Greece in the long-run and the short-run. Further, productivity in the public sector is lower than in the private sector and the growth of income is not an important determinant of the increase in the relative size of public spending.     

Modeling SSI financial eligibility and simulating the effect of policy options

This article simulates eligibility for Supplemental Security Income (SSI) among the elderly, analyzes factors affecting participation, and looks at the potential effects of various options to modify financial eligibility standards for the federal SSI program. We find that in the estimated noninstitutional elderly population of 30.2 million in the United States in 1991, approximately 2 million individuals aged 65 or older were eligible for SSI (a 6.6 percent rate of eligibility). Our overall estimate of the rate of participation among eligible elderly is approximately 63 percent, suggesting that more than a third of those who are eligible do not participate in the program. The results of our analysis of factors affecting participation among the eligible elderly show that expected SSI benefits and a number of demographic and socioeconomic variables are associated with the probability of participation. We also simulate the effects of various policy options on the poverty rate, poverty gap, annual program cost, the number of participants, and the average estimated benefits among participants. The simulations consider the potential effects of five policy alternatives: Increase the general income exclusion (GIE) from $20 to $80. Increase the earned income exclusion (EIE) from $65 to $260. Increase the federal benefit rate (FBR) by $50 for individuals and $75 for couples and eliminate the GIE. Increase the asset threshold to $3,000 for individuals and $4,500 for couples. Increase the asset threshold to $6,000 for individuals and $9,000 for couples. Using 1991 microdata from the Survey of Income and Program Participation (SIPP) matched to Social Security Administration administrative records and making adjustments reflecting aggregate program statistics, we present the results of our simulations for December 1999. The results show substantial variation in the simulated effects of the five policy alternatives along the various outcome dimensions considered. The simulated effects on the poverty gap of the elderly population range from a 7.9 percent reduction ("Increase the GIE from $20 to $80") to a 0.1 percent reduction ("Increase the EIE from $65 to $260"). All simulated interventions are expected to increase the rate of SSI participation among the elderly from a high of 20.3 percent ("Increase the GIE from $20 to $80") to a low of 0.5 percent ("Increase the EIE from $65 to $260"). We also find that the interventions that have greater estimated effects in terms of increased participation and reduced poverty tend to cost more. At the high end, we estimate that increasing the GIE from $20 to $80 could raise annual federal SSI cash benefit outlays by about 46 percent, compared with only 0.9 percent for increasing the EIE from $65 to $260. Similar to the EIE intervention, raising the resource thresholds by 50 percent would reduce the overall poverty gap of the elderly by only 0.2 percent, would increase SSI participation only modestly (by 1.3 percent), but would entail slightly higher program costs (by 1.4 percent). Increasing the asset threshold by 200 percent would have higher estimated effects on all three outcomes, but it would still be associated with relatively low increases in both costs and benefits. Finally, the simulated effects on the three key outcomes of increasing the FBR by $50 for individuals and $75 for couples, combined with eliminating the GIE, are relatively large but are clearly less substantial than increasing the GIE from $20 to $80. This work relies on data from the SIPP matched to administrative data on federal SSI benefits that provide a more accurate picture of SSI participation than has been feasible for previous studies. We simulate eligibility for federal SSI benefits by applying the program rules to detailed information on the characteristics of individuals and couples based on the rich array of demographic and socioeconomic data in the SIPP, particularly the comprehensive information SIPP provides on assets and monthly income. A probit model is estimated to analyze factors affecting participation among the eligible elderly. Finally, we conduct the policy simulations using altered program rules represented by the policy alternatives and predicted participation probabilities to estimate outcomes under simulated program rules. We compare those simulated outcomes to observed outcomes under current program rules. The results of our simulations are conditional on the characteristics of participants and eligibles in 1991, but they also reflect aggregate adjustments capturing substantial changes in overall participation and program benefit levels between 1991 and 1999.