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Medicaid expansion and the mental health of spousal caregivers

Author

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  • Raut, Nilesh
  • Costa-Font, Joan
  • Van-Houtven, Courtney
Abstract
Health insurance expansions can exert wellbeing effects on individuals who provide informal care to their loved ones, reducing their experience of depression. This study exploits evidence from the Patient Protection and Affordable Care Act’s Medicaid expansion (ACA Medicaid) to examine the effects on the mental wellbeing of informal caregivers. Drawing on an event study and a Difference-in-Differences (DID) design we investigate the policy impact of ACA Medicaid using longitudinal evidence (from the Health and Retirement Study, HRS) for low-income individuals aged 64 or below. We find that ACA Medicaid reduced the likelihood of depressive symptoms among spousal caregivers. We document that exposure to ACA Medicaid gives rise to 8.2% points (on average, equivalent to 30% decrease) reduction in the feeling of depression and 8.7% points increase in the feeling of happiness (on average, 11% increase). The estimates are robust to various specifications, are driven by reductions in out of -pocket expenses and labor supply and, as expected, increased after Medicaid uptake. The evidence from falsification tests confirms that the estimated effects are likely due to ACA Medicaid.

Suggested Citation

  • Raut, Nilesh & Costa-Font, Joan & Van-Houtven, Courtney, 2023. "Medicaid expansion and the mental health of spousal caregivers," LSE Research Online Documents on Economics 119977, London School of Economics and Political Science, LSE Library.
    • Handle: RePEc:ehl:lserod:119977
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    References listed on IDEAS

    as
    1. Benjamin W. Cowan & Zhuang Hao, 2020. "Medicaid Expansion and the Mental Health of College Students," NBER Working Papers 27306, National Bureau of Economic Research, Inc.
    2. Van Houtven, Courtney Harold & Coe, Norma B. & Skira, Meghan M., 2013. "The effect of informal care on work and wages," Journal of Health Economics, Elsevier, vol. 32(1), pages 240-252.
    3. Kosali Simon & Aparna Soni & John Cawley, 2017. "The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(2), pages 390-417, March.
    4. Michael Lechner & Nuria Rodriguez-Planas & Daniel Fernández Kranz, 2016. "Difference-in-difference estimation by FE and OLS when there is panel non-response," Journal of Applied Statistics, Taylor & Francis Journals, vol. 43(11), pages 2044-2052, August.
    5. Puhani, Patrick A., 2012. "The treatment effect, the cross difference, and the interaction term in nonlinear “difference-in-differences” models," Economics Letters, Elsevier, vol. 115(1), pages 85-87.
    6. Susan Athey & Guido W. Imbens, 2006. "Identification and Inference in Nonlinear Difference-in-Differences Models," Econometrica, Econometric Society, vol. 74(2), pages 431-497, March.
    7. William H. Greene & Min (Shirley) Liu, 2020. "Review of Difference-in-Difference Analyses in Social Sciences: Application in Policy Test Research," World Scientific Book Chapters, in: Cheng Few Lee & John C Lee (ed.), HANDBOOK OF FINANCIAL ECONOMETRICS, MATHEMATICS, STATISTICS, AND MACHINE LEARNING, chapter 124, pages 4255-4280, World Scientific Publishing Co. Pte. Ltd..
    8. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1057-1106.
    9. Matthew Panhans, 2019. "Adverse Selection in ACA Exchange Markets: Evidence from Colorado," American Economic Journal: Applied Economics, American Economic Association, vol. 11(2), pages 1-36, April.
    10. Sarah Miller & Luojia Hu & Robert Kaestner & Bhashkar Mazumder & Ashley Wong, 2021. "The ACA Medicaid Expansion in Michigan and Financial Health," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(2), pages 348-375, March.
    11. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2016. "Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non-Expansion States," NBER Working Papers 22182, National Bureau of Economic Research, Inc.
    12. Goda, Gopi Shah, 2011. "The impact of state tax subsidies for private long-term care insurance on coverage and Medicaid expenditures," Journal of Public Economics, Elsevier, vol. 95(7-8), pages 744-757, August.
    13. Angrist, Joshua D. & Krueger, Alan B., 1999. "Empirical strategies in labor economics," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 23, pages 1277-1366, Elsevier.
    14. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    15. Benjamin W. Cowan & Zhuang Hao, 2021. "Medicaid expansion and the mental health of college students," Health Economics, John Wiley & Sons, Ltd., vol. 30(6), pages 1306-1327, June.
    16. Norma B. Coe & Courtney Harold Van Houtven, 2009. "Caring for mom and neglecting yourself? The health effects of caring for an elderly parent," Health Economics, John Wiley & Sons, Ltd., vol. 18(9), pages 991-1010, September.
    17. Schmitz, Hendrik & Stroka, Magdalena A., 2013. "Health and the double burden of full-time work and informal care provision — Evidence from administrative data," Labour Economics, Elsevier, vol. 24(C), pages 305-322.
    18. Courtney Houtven & Michele Wilson & Elizabeth Clipp, 2005. "Informal Care Intensity and Caregiver Drug Utilization," Review of Economics of the Household, Springer, vol. 3(4), pages 415-433, December.
    19. Ai, Chunrong & Norton, Edward C., 2003. "Interaction terms in logit and probit models," Economics Letters, Elsevier, vol. 80(1), pages 123-129, July.
    20. Robert Kaestner & Bowen Garrett & Jiajia Chen & Anuj Gangopadhyaya & Caitlyn Fleming, 2017. "Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(3), pages 608-642, June.
    21. Xuesong Han & Binh T Nguyen & Jeffrey Drope & Ahmedin Jemal, 2015. "Health-Related Outcomes among the Poor: Medicaid Expansion vs. Non-Expansion States," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-11, December.
    22. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2017. "Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non‐Expansion States," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(1), pages 178-210, January.
    23. McGuire, Thomas G. & Newhouse, Joseph P. & Normand, Sharon-Lise & Shi, Julie & Zuvekas, Samuel, 2014. "Assessing incentives for service-level selection in private health insurance exchanges," Journal of Health Economics, Elsevier, vol. 35(C), pages 47-63.
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    • I10 - Health, Education, and Welfare - - Health - - - General

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