Working Paper: NBER ID: w20348
Authors: Alan C. Monheit; Irina Grafova; Rizie Kumar
Abstract: Families in constrained economic circumstances resulting from economic shocks face difficult choices regarding how best to spend their diminished resources. As families strive to preserve their living standards, decisions regarding health care use and its allocation among family members may become more discretionary and complex. Using two-year panel data from the Medical Expenditure Panel Survey for 2004 to 2011, we examine how the intra-family allocation of health care spending responds to realized and anticipated changes in family economic status. We focus on the share of total family health care spending allocated to children, and measure realized economic shocks based on changes in the family's income, employment, and health insurance status. We account for anticipated economic shocks by differentiating families by whether they are observed prior to, at the onset of, or during the Great Recession, or in the post-recession period. Our findings suggest that both types of economic shocks affect the share of family health care spending allocated to children, with findings more pronounced for single-mother families. We also find that realized economic shocks have a greater impact on children's spending share than the anticipated change in economic status associated with the Great Recession and its recovery.
Keywords: No keywords provided
JEL Codes: I12; I13; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| realized economic shocks (F69) | allocation of health care spending to children (H51) |
| anticipated economic shocks (E32) | allocation of health care spending to children (H51) |
| transition from employment to unemployment (J63) | allocation of health care spending to children (H51) |
| decline in economic status to poor or near-poor levels (I32) | allocation of health care spending to children (H51) |