{"title":"Medicaid Coverage Across the Income Distribution Under the Affordable Care Act","authors":"Charles Courtemanche, J. Marton, Aaron Yelowitz","doi":"10.2139/ssrn.3453432","DOIUrl":"https://doi.org/10.2139/ssrn.3453432","url":null,"abstract":"This paper examines trends in Medicaid enrollment across the income distribution after the ACA’s Medicaid expansion. Using data from the American Community Survey between 2012 and 2017, we compare Medicaid coverage over time in 9 states that expanded Medicaid in 2014 with no previous expansion for able-bodied, working-age adults with 12 states that had not expanded Medicaid by 2019 and also had no previous expansion for such adults. A difference-in-differences model is used to formalize this comparison. Similar to many previous studies, we find that Medicaid coverage increased dramatically for income-eligible adults under 138% of the federal poverty level (FPL). In addition, we show that Medicaid participation increased by 3.0 percentage points for those with incomes above 138% of the FPL from a pre-ACA baseline of 2.7% among this group. While we cannot say with certainty why these individuals were able to participate in Medicaid, we offer several potential explanations that should be the subject of future work. For example, it is possible that the ACA Medicaid expansions were administered differently at the state or local level than federal rules would require, similarly to differences between effective tax rates and statutory tax rates in many transfer programs.","PeriodicalId":137820,"journal":{"name":"Political Economy: National","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131415910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An Economic History of Troon","authors":"E. Sutherland","doi":"10.2139/ssrn.3426423","DOIUrl":"https://doi.org/10.2139/ssrn.3426423","url":null,"abstract":"The town of Troon was created during the ‘industrial revolution’, a natural port protected by an intrusion of igneous rock, first exploited for the export of coal from 1811 at the instigation of the future 4th Duke of Portland. Coal exports grew quickly and continued until 1968. Shipbuilding was introduced in the 1810s, then boosted in the 1880s by the Marquis of Ailsa, but closed in 2000, while a railway company built and repaired carriages and waggons from 1900 until 1971. From 1811 some passengers travelled on the coal tramway from Kilmarnock to explore the seaside and bathe at Troon, taken up more seriously with the railway to Glasgow in 1839, enabling wealthier citizens of Glasgow, Kilmarnock and Paisley to build, buy or rent a seaside home to enjoy during the summer. Golf emerged as a recreational activity in the 1870s with elite private clubs, then democratised by municipal courses from 1905. Although industry stalled and faded away, Troon continued to expand as a residential town, initially in garden suburbs with a few grand mansions, but latterly more densely packed.","PeriodicalId":137820,"journal":{"name":"Political Economy: National","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114982103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Understanding Day Care Enrolment Gaps","authors":"Jonas Jessen, S. Schmitz, Sevrin Waights","doi":"10.1016/J.JPUBECO.2020.104252","DOIUrl":"https://doi.org/10.1016/J.JPUBECO.2020.104252","url":null,"abstract":"","PeriodicalId":137820,"journal":{"name":"Political Economy: National","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"118274572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Layton, Nicole Maestas, Dániel Prinz, B. Vabson
{"title":"Private vs. Public Provision of Social Insurance: Evidence from Medicaid","authors":"T. Layton, Nicole Maestas, Dániel Prinz, B. Vabson","doi":"10.3386/W26042","DOIUrl":"https://doi.org/10.3386/W26042","url":null,"abstract":"Public health insurance benefits in the U.S. are increasingly provided by private firms, despite mixed evidence on welfare effects. We investigate the impact of privatization in Medicaid by exploiting the staggered introduction of county-level mandates in Texas that required disabled beneficiaries to switch from public to private plans. Compared to the public program, which used blunt rationing to control costs, we find privatization led to improvements in healthcare—including increased consumption of high-value drug treatments and fewer avoidable hospitalizations—but also higher Medicaid spending. We conclude that private provision can be beneficial when constraints in the public setting limit efficiency.","PeriodicalId":137820,"journal":{"name":"Political Economy: National","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127747735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sharing a Government","authors":"J. Ventura","doi":"10.3386/W26141","DOIUrl":"https://doi.org/10.3386/W26141","url":null,"abstract":"This paper develops a simple theoretical framework to study a set of regions, each with its own regional government, who share a union or central government. These governments must decide whether to implement or discard a large number of projects that produce local benefits for the region that implements them, and externalities for the rest of the regions. Conflict or disagreement arises since different regions value projects differently. The classic assignment problem consists of deciding who decides these projects, either the union or the regional governments. It is well known that regional governments are insensitive to externalities. The key observation here is that the union government is insensitive to local benefits. Thus, each government maximizes only a piece of the value of projects, and disregards the other one. This observations leads to simple and clear rules for solving the assignment problem.","PeriodicalId":137820,"journal":{"name":"Political Economy: National","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125242360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The New Intergovernmentalism and the Euro Crisis: A Painful Case?","authors":"D. Hodson","doi":"10.2139/ssrn.3412326","DOIUrl":"https://doi.org/10.2139/ssrn.3412326","url":null,"abstract":"The new intergovernmentalism seeks to understand the changing dynamics of contemporary European integration. It emphasises, inter alia, member states’ preference for deliberative modes of decision-making and their reluctance to delegate new powers to traditional supranational institutions. The euro crisis is sometimes seen as a difficult case for the new intergovernmentalism because of the perceived importance of hard bargaining over crisis measures during this episode and the new roles entrusted to the European Commission and the European Central Bank under crisis reforms. Such criticisms, this paper argues, overlook: the importance of high-level consensus-seeking and deliberation in saving the single currency; the disparate forms of delegation deployed to preserve member state influence over Economic and Monetary Union; and the extent to which the euro crisis has amplified the European Union’s political disequilibrium. Far from running counter to the new intergovernmentalism, it concludes, the euro crisis exemplifies the turbulent dynamics of the post-Maastricht period.","PeriodicalId":137820,"journal":{"name":"Political Economy: National","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128856847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Can Centralized Performance Budgeting Systems Be Useful for Line Ministries? Evidence from Chile","authors":"J. P. Martínez Guzmán","doi":"10.1111/pbaf.12214","DOIUrl":"https://doi.org/10.1111/pbaf.12214","url":null,"abstract":"Many governments that have implemented performance budgeting systems have followed a centralized, top‐down approach that makes them foreign to the needs of line ministries. In this study, the author analyzes the case of Chile, which despite its top‐down approach, is often regarded as successful. Our findings suggest that while top‐down performance budgeting systems often fail to meet the needs of individual ministries and are prone to principal‐agent issues, under certain conditions—such as involving third‐party experts and having a professional civil service—the performance information from those systems might still be useful and/or might generate positive spillovers for line ministries.","PeriodicalId":137820,"journal":{"name":"Political Economy: National","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129600821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Decentralisation Research Paper","authors":"M. Zulfa","doi":"10.2139/ssrn.3442109","DOIUrl":"https://doi.org/10.2139/ssrn.3442109","url":null,"abstract":"Decentralisation in the Maldives was first attempted in the Maldives in the 1990s and later enshrined in the Constitution of the Maldives in 2008. However for various reasons decentralisation has not been successful. This paper argues that political will and genuine commitment from the people are required to animate the provisions of the constitution.","PeriodicalId":137820,"journal":{"name":"Political Economy: National","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116082576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Subnational Border Reforms and Economic Development in Africa","authors":"T. Baskaran, Sebastian Blesse","doi":"10.2139/ssrn.3184208","DOIUrl":"https://doi.org/10.2139/ssrn.3184208","url":null,"abstract":"Arbitrarily designed borders have been identified by a recent literature as an important reason why sub-Saharan Africa remains one of the poorest regions on the globe. Accordingly, border changes may be a way to promote growth on the African continent. In this paper, we study the effect of subnational border reforms on local economic development (proxied by nighttime luminosity) by tracking provincial-level border changes in Africa during 1992-2013 with GIS techniques. Difference-in-difference regressions suggest that mergers have strong positive effects on economic development. Splits, too, have positive effects, but they are substantially smaller on average. To understand why the economic impact of splits and mergers differs in magnitude, we investigate transmission channels. We link border changes to geocoded conflict data and survey evidence on political attitudes. We find that the differences between splits and mergers are possibly due to different underlying motives for these two types of border reforms. Splits seem to affect development through higher political stability, i.e. a lower incidence of conflicts and more benign political attitudes of citizens, while mergers presumably work through an improvement in administrative efficiency.","PeriodicalId":137820,"journal":{"name":"Political Economy: National","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115887847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Healthcare Spending Overshoots a Threat to Sustainability","authors":"W. Robson","doi":"10.2139/ssrn.3382360","DOIUrl":"https://doi.org/10.2139/ssrn.3382360","url":null,"abstract":"Growth in healthcare spending by provinces and territories has been accelerating over the last four years as governments continue to overshoot their budget targets, says a report from the C.D. Howe Institute. In “Healthcare Spending Overshoots a Threat to Sustainability,” author William B.P. Robson warns that, while governments are typically budgeting growth in healthcare budgets that should be fiscally sustainable, actual growth in healthcare costs is outrunning what Canada’s economy and tax base can support over the long run.","PeriodicalId":137820,"journal":{"name":"Political Economy: National","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122317730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}