Working Paper: NBER ID: w31223
Authors: Paul Goldsmith-Pinkham; Maxim Pinkovskiy; Jacob Wallace
Abstract: We use a five percent sample of Americans’ credit bureau data, combined with a regression discontinuity approach, to estimate the effect of universal health insurance at age 65—when most Americans become eligible for Medicare—at the national, state, and local level. We find a 30 percent reduction in debt collections—and a two-thirds reduction in the geographic variation in collections—with limited effects on other financial outcomes. The areas that experienced larger reductions in collections debt at age 65 were concentrated in the Southern United States, and had higher shares of black residents, people with disabilities, and for-profit hospitals.
Keywords: Medicare; Consumer Financial Strain; Health Insurance; Geographic Variation; Debt Collections
JEL Codes: G51; I13
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| reduction in the number of uninsured individuals (G52) | improved financial health (G59) |
| Medicare expansion (I18) | financial health outcomes across commuting zones (R29) |
| Medicare eligibility at age 65 (I13) | reduction in debt collections (G33) |
| Medicare eligibility at age 65 (I13) | reduction in geographic variation in debt collections (G51) |
| Medicare eligibility at age 65 (I13) | financial health improvements (G51) |
| Medicare eligibility at age 65 (I13) | geographic variation in financial health outcomes (I14) |
| Medicare eligibility at age 65 (I13) | credit scores (G51) |
| Medicare eligibility at age 65 (I13) | bankruptcy rates (K35) |