"Missing Prescriptions: Loss of Employer-Provided Health Insurance and Insulin Use Among Individuals with Diabetes" (Under Review)
(An older version of this paper circulated as "Does Insurance for Treatment Crowd Out Prevention? Evidence from Diabetics' Insulin Usage")
I examine the impact of Medicare coverage on individuals with diabetes. Americans with diabetes are 4 percentage points less likely to use insulin once they qualify for Medicare coverage. This decline is offset by an increase in usage following the advent of Medicare prescription drug coverage (Part D) in 2006. By exploiting the panel aspect of the Health and Retirement Study data, I show that the pre-2006 decline in insulin usage at age 65 is due to a large decline in private prescription drug coverage among individuals with diabetes around age 65, with a corresponding increase in out-of-pocket costs among continual insulin users, rather than moral hazard. I estimate an own-price demand elasticity for insulin of -0.28, an order of magnitude larger than prior estimates for this class of prescription medications. The results are driven by individuals who lose private prescription drug coverage around age 65 delaying the beginning of insulin therapy, suggesting that individuals with Type II diabetes who are on the verge of beginning to use insulin are more sensitive to its price than experienced users.
"Household Debt, Self-Insurance, and Subjective Medical Expenses Risk" (Submitted)
(An older version of this paper circulated as "The Effect of Medical Expenses Risk on Debt: A Nonparametric Bounds Analysis")
I examine the effect of medical expenses risk on debt. Before an anticipated medical expenses shock occurs, individuals should be less likely to take on debt and pay off existing debts in anticipation of lower future consumption, while ex post it is rational to take on debt to smooth consumption. I estimate changes to subjective forecasts of future medical expenses and debt in the months leading up to Medicare eligibility, as well as upper bounds for the effect of new information on debt for Medicare enrollees. The results indicate that increased borrowing in the face of lower risk is less prevalent than higher debt following a realized shock, accounting for the positive relationship between forecast medical expenses risk and debt in the data.
Work in Progress
"Going Off-Script: Physician Licence Suspension and Health Outcomes for Medicaid Patients" (with Emma Boswell Dean and Mallick Hossain)
"Honest Inference for Discrete Outcomes" (with Walter Beckert)
"Shelter from the Storm? The Effect of Housing Wealth Shocks on the Demand for Prevention and Insurance" (with Gregory S. Burge and Lingxiao Zhao)