Elwell, James Philip2019-10-152019-10-152019-05-30Elwell_cornellgrad_0058F_11386http://dissertations.umi.com/cornellgrad:11386bibid: 11050279https://hdl.handle.net/1813/67297My dissertation investigates different aspects of transfer programs in the United States, contributes to our understanding of interactions between safety-net programs, and improves the data available to measure recipiency of these programs historically. In my first chapter I investigate how gaining eligibility for Medicaid affects the way families interact with other parts of the safety net and the labor market. The U.S. has many of programs with different eligibility criteria and substantial overlap on a family's budget constraint. I use large expansions of Medicaid eligibility to instrument for the effect of Medicaid on take-up, participation, and eligibility for other programs including cash welfare, food stamps, housing subsidies, and wage subsidies. Combining Current Population Survey data with a difference-in-differences framework, I find that expansions targeting the lowest-income families increased participation in other major programs including food stamps, cash welfare, and rental subsidies. However, effects on program participation obscure larger, offsetting increases in program take-up (participation among eligibles) and reductions in program eligibility. I find that Medicaid expansions increased family labor supply, consistent with the reduction in program eligibility. These spillovers imply that Medicaid expansions for children had two substantial, unintended benefits: more eligible children received safety net benefits and fewer children were eligible due to increased family incomes. The second chapter, coauthored with Professor Richard V. Burkhauser, investigates how the creation of major safety net programs affected trends in income and is distribution. We extend Census Bureau estimates of the market value of in-kind transfers including Medicare and Medicaid as well as employer-provided health insurance from 1979 back to 1967 using Current Population Survey data and couple it with decennial Census data for 1959. Using these data, we provide a fresh look at the twenty-year period 1959 to 1979 that encompasses the start of New Frontier and Great Society programs. We show that conventional measures of median income and income inequality that exclude the market value of in-kind transfers, including Medicare and Medicaid, will substantially understate the success of government policies in offsetting the stagnation of median market income growth and the rise in market income inequality since 1969. In the third chapter, I explore the relationship between income and out-of-pocket health care expenditures among the elderly. Health care expenditures have risen rapidly in the United States over the last 50 years, and rising incomes are one potential contributor to this increase. Using an instrument for Social Security income to capture variation exogenously introduced by Congress during the 1970s, I show that less-educated households have a large income-elasticity of demand for health care, as well as additional health insurance coverage and increased health care utilization. The elasticities are sufficiently large to indicate that rising incomes are an important contributor to rising expenditures, at least among the less-educated elderly.en-USEconomicsLabor Economicsdissertation or thesishttps://doi.org/10.7298/rqzx-n705