Journal of Policy Analysis and Management

Stable housing is critical for health, employment, education, and other social outcomes. Evictions reflect a form of housing instability that is experienced by millions of Americans each year. Inadequately treated psychiatric disorders have the potential to influence evictions in several ways. For example, these disorders may impede labor market performance and thus the ability to pay rent, or increase the likelihood of risky and/or nuisance behaviors that can lead to a lease violation. We estimate the effect of local access to psychiatric treatment on eviction rates...

E-cigarette taxes are an active area of legislation and have important regulatory implications by proxying e-cigarette accessibility. We examine the effect of e-cigarette taxes on prepregnancy and prenatal smoking using the near-universe of births to mothers conceiving between 2013 and 2019 in the United States. Using fixed effect regressions, we show that e-cigarette taxes increase prepregnancy and prenatal smoking. We also find evidence that e-cigarette taxes reduce prepregnancy and 3rd trimester e-cigarette use...

Value-based payment programs, also known as pay-for-performance, use financial incentives to motivate providers to invest in quality and are a critical part of Medicare health care reform. This study examines the first year of the Home Health Value-Based Purchasing program, a nationally representative cluster randomized experiment implemented by the Centers for Medicare & Medicaid Services in 2016. The goal of the program is to achieve better home health care quality. Home health agencies in treatment states were rewarded or penalized based on their performance on agency-reported and non-agency-reported quality measures...

Many public school diversity efforts rely on reassigning students from one school to another. While opponents of such efforts articulate concerns about the consequences of reassignments for students' educational experiences, little evidence exists regarding these effects, particularly in contemporary policy contexts. Using an event study design, we leverage data from an innovative socioeconomic school desegregation plan to estimate the effects of reassignment on reassigned students' achievement, attendance, and exposure to exclusionary discipline...

COVID symptom screening, a new workplace practice, is already affecting many millions of American workers. As of this writing, 34 states already require, and federal guidance recommends, frequent screening of at least some employees for fever or other symptoms. This paper provides the first empirical work identifying major features of symptom screening in a broad population and exploring the trade-offs employers face in using daily symptom screening. First, we find that common symptom checkers could screen out up to 7 percent of workers each day, depending on the measure used...

For many low-income Medicare beneficiaries, Medicaid provides important supplemental insurance that covers out-of-pocket costs and additional benefits. We examine whether Medicaid participation by low-income adults age 65 and up increased as a result of Medicaid expansions to working-age adults under the Affordable Care Act (ACA). Previous literature documents so-called "welcome mat" effects in other populations but has not explicitly studied older persons dually eligible for Medicare and Medicaid. We extend this literature by estimating models of Medicaid participation among persons age 65 and up using American Community Survey data from 2010 to 2017 and state variation in ACA Medicaid expansions...

A lack of affordable housing is a pressing issue for many low-income American families and can lead to eviction from their homes. Housing assistance programs to address this problem include public housing and other assistance, including vouchers, through which a government agency offsets the cost of private market housing. This paper assesses whether the receipt of either category of assistance reduces the probability that a family will be evicted from their home in the subsequent six years. Because no randomized trial has assessed these effects, we use observational data and formalize the conditions under which a causal interpretation is warranted...

How should schools assign students to more rigorous math courses so as best to help their academic outcomes? We identify several hundred California middle schools that used 7th-grade test scores to place students into 8th-grade algebra courses and use a regression discontinuity design to estimate average impacts and heterogeneity across schools. Enrolling in 8th-grade algebra boosts students' enrollment in advanced math in ninth grade by 30 percentage points and eleventh grade by 16 percentage points. Math scores in tenth grade rise by 0...

Medicare is a large government health insurance program in the United States that covers about 60 million people. This paper analyzes the effects of Medicare insurance on health for a group of people in urgent need of medical care: people with cancer. We used a regression discontinuity design to assess impacts of near-universal Medicare insurance at age 65 on cancer detection and outcomes, using population-based cancer registries and vital statistics data. Our analysis focused on the three tumor sites for which screening is recommended both before and after age 65: breast, colorectal, and lung cancer...

Low participation rates in government assistance programs are a major policy concern in the United States. This paper studies take-up of Section 8 housing vouchers, a program in which take-up rates are quite low among interested and eligible households. We link 18,109 households in Chicago that were offered vouchers through a lottery to administrative data and study how baseline employment, earnings, public assistance, arrests, residential location, and children's academic performance predict take-up. Our analysis finds mixed evidence of whether the most disadvantaged or distressed households face the largest barriers to program participation...

We use experimental survey methods in a nationally representative survey to test alternative ways of identifying (1) individuals in the population who would be better able to work if they received workplace accommodation for a health condition; (2) the rate at which these individuals receive workplace accommodation; and (3) the rate at which accommodated workers are still working four years later, compared to similar workers who were not accommodated. We find that question order in disability surveys matters...

Older adults are at elevated risk of reducing labor supply due to poor health, partly because of high rates of symptoms that may be alleviated by medical marijuana. Yet, surprisingly little is known about how this group responds to medical marijuana laws (MMLs). We quantify the effects of state medical marijuana laws on the health and labor supply of adults age 51 and older, focusing on the 55 percent with one or more medical conditions with symptoms that may respond to medical marijuana. We use longitudinal data from the Health and Retirement Study to estimate event study and differences-in-differences regression models...

We examine the effect of Medicaid expansion under the Affordable Care Act (ACA) on substance use disorder (SUD) treatment utilization and financing. We combine data on admissions to specialty facilities and Medicaid-reimbursed prescriptions for medications commonly used to treat SUDs in nonspecialty outpatient settings with an event-study design. Several findings emerge from our study. First, among patients receiving specialty care, Medicaid coverage and payments increased. Second, the share of patients who were uninsured and who had treatment paid for by state and local government payments declined...

We consider the distributional implications of Social Security policy changes in the context of increases in life expectancy and differential mortality. Using a robust microsimulation model, we examine how several options for raising the retirement age, including a scenario that applies a mortality adjustment in combination with such policies, affect different types of individuals and households. Policy changes are simulated for Social Security beneficiaries in 2030 using the Modeling Income in the Near Term (MINT) microsimulation model...

Despite the significant cost of prescription (Rx) drug abuse and calls from policymakers for effective interventions, there is limited research on the effects of policies intended to limit such abuse. This study estimates the effects of prescription drug monitoring (PDMP) programs, which constitute a key policy targeting access to non-medical use of Rx drugs. Based on objective indicators of abuse as measured by substance abuse treatment admissions and mortality related to Rx drugs, estimates do not suggest any substantial effects of instituting an operational PDMP...

The effects of paid parental leave policies on infant health have yet to be established. In this paper we investigate these effects by exploiting the introduction of California Paid Family Leave (PFL), the first program in the U.S. that specifically provides working parents with paid time off for bonding with a newborn. We measure health using the full census of infant hospitalizations in California and a set of control states, and implement a differences-in-differences approach. Our results suggest a decline in infant admissions, which is concentrated among those causes that are potentially affected by closer childcare (and to a lesser extent breastfeeding)...

Household food insecurity status in the United States is ascertained by a battery of close-ended questions. We posit that the monthly nature of benefit receipt from the Supplemental Nutrition Assistance Program (SNAP) creates experiences of food hardship, which become salient in the context of SNAP receipt, and in turn exert influence on the response to food security questions. We test this hypothesis by examining answers to a 30-day food security module in relation to when SNAP benefits are received. We find that for SNAP households near the end of or at the beginning of the benefit month, the probability of being classified as food insecure increases by 11 percentage points, over a baseline of 42 percent...

Transaction costs pose significant barriers to participation in public programs. We analyze how Social Security Disability Insurance (SSDI) application behavior was affected by iClaim, a 2009 innovation that streamlined the online application process. We use a difference-in-differences design to compare application rates before and after 2009 across counties with varying degrees of access to high-speed internet. We estimate that counties with internet connectivity one standard-deviation above the mean experienced a 1...

Tougher immigration enforcement was responsible for 1.8 million deportations between 2009 and 2013 alone--many of them were fathers of American children. We exploit the geographic and temporal variation in the escalation of interior immigration enforcement to assess its impact on the structure of families to which many of the deported fathers of U.S.-born children belonged. We find that the average increase in immigration enforcement during the 2005 to 2015 period has raised by 19 percent the likelihood that Hispanic U...

This study analyzes the short-term impact of an exogenous, positive income shock on caregivers' subjective well-being (SWB) in Malawi using panel data from 3,365 households targeted to receive Malawi's Social Cash Transfer Program that provides unconditional cash to ultra-poor, labor-constrained households. The study consists of a cluster-randomized, longitudinal design. After the baseline survey, half of these village clusters were randomly selected to receive the transfer and a follow-up was conducted 17 months later...