Essays On The Interaction Between Children'S Health Insurance And Parental Circumstances

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In the first chapter of this dissertation, I study the effect of child support health insurance mandates on children's health insurance coverage. Children are more likely to lose health insurance when their parents divorce or separate, which is problematic because lack of health insurance is associated with reduced preventive care, diagnosis of diseases at later stages, and higher mortality. In order to increase coverage for children and reduce costs associated with public health insurance, many states have passed child support laws which mandate that a parent provide health insurance for the children if it is available at a reasonable cost. This paper is the first to evaluate the impact of these statutes on the number of children who lose health insurance due to parental divorce or separation. I codify the relevant laws by state and year from 1990 through 2007 in terms of the presence of mandates and the number and type of enforcement mechanisms. These variables are then linked to panels of the Survey of Income and Program Participation (SIPP), which provide the remainder of the necessary variables. Three main regressions are estimated. The first measures the overall effect of child support health insurance mandates on children's insurance coverage. The second equation measures the first intermediate step, whether child support health insurance mandates result in an order in the child support agreement to provide health insurance. The third equation measures the second intermediate step, whether an order for the parents to provide health insurance results in insurance coverage for children. I find that child support laws requiring parents to provide health insurance do not significantly impact the presence or type of health insurance coverage for children of divorced or separated parents. Additionally, these laws do not increase the probability that the child support agreement contains an order to provide health insurance, and an order to provide health insurance does not increase the probability of either any coverage or private coverage. In the second paper, we study the relationship between divorce and health insurance. Changing marital status is an important source of health insurance change. However, neither the health nor family economics literatures have examined this phenomenon. Using the SIPP, we document how health insurance status changes over time for men, women, and children as divorce and separation occur, as well as the likely causes of these changes. We find modest changes in overall coverage, but these changes mask large changes in type of coverage as people divorce or separate. In the third paper, we look at the effects of government aid expansions on labor market outcomes. While many studies investigate the magnitude by which public insurance expansions 'crowdout' private coverage, we ask a question new question: are such families able to recoup the benefits of no longer relying on employer provided coverage for children when they move to public coverage? Our findings from the SIPP do not show noticeable improvements, though our findings from the Current Population Survey (CPS) show a positive and significant effect on income and hourly wages.

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Health Insurance; Child Support; Divorce


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Simon, Kosali I.

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Peters, H. Elizabeth

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Blau, Francine D

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Ph. D., Economics

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Doctor of Philosophy

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dissertation or thesis

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