Working Paper: NBER ID: w10092
Authors: John Cawley; Kosali I. Simon
Abstract: The primary objective of this paper is to improve our understanding of the historic relationship between state and national macroeconomic climate and the health insurance coverage of Americans. The secondary objective of this paper is to use the historic findings to estimate how the number of uninsured Americans changed during the 2001 recession, and to estimate whether to date enough people have gained health insurance during the current recovery to offset the losses during the recession. We conclude that the macroeconomy (measured by state unemployment rate and real gross state product) is correlated with the probability of men's health insurance coverage and that this correlation is only partly explained by changes in men's employment status. Counter-cyclical health insurance programs such as Medicaid and the State Children's Health Insurance Program seem to ensure that the health insurance coverage of women and children is insulated from macroeconomic changes. We estimate that 851,000 Americans, the vast majority of whom were adult men, lost health insurance due to macroeconomic conditions alone during the 2001 recession.
Keywords: Health Insurance; Macroeconomy; Unemployment; Medicaid; SIPP
JEL Codes: I10; J3; J6; E32
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| State unemployment rate (J64) | Probability of health insurance coverage for adult men (I13) |
| Real per capita gross state product (R19) | Probability of health insurance coverage (I13) |
| Macroeconomic conditions (E66) | Health insurance coverage loss (G52) |
| Macroeconomic conditions (E66) | Health insurance coverage gain (G52) |
| Macroeconomic fluctuations (E39) | Women's and children's insurance coverage (I13) |