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HEALTH, HEALTH INSURANCE AND WELFARE DYNAMICS

健康、健康保险和福利动态

基本信息

批准号：
2718615
负责人：
KRISTA M PERREIRA
金额：
$ 3.1万
依托单位：
UNIVERSITY OF CALIFORNIA BERKELEY
依托单位国家：
美国
项目类别：
财政年份：
1998
资助国家：
美国
起止时间：
1998-08-01 至 1999-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/2718615
关键词：
Medicare /Medicaid behavioral /social science research tag child with disability health insurance health services research tag human data immigrant marriage /marital status medical indigency parent deprivation person with disability public assistance socioeconomics

项目摘要

This analysis is divided into two related components. In the first component, referred to as the demand-side analysis, exits from the Medicaid program are modeled as a function of local labor market conditions, the availability of private health insurance, and, among single mothers on welfare, the quantity and quality of available spouses. Separate models are developed for five groups of Medicaid participants: (1) single-parent families, (2) two-parent families, (3) blind or disabled children, (4) blind or disabled adults, and (5) immigrants. In the second component, referred to as the supply-side analysis, exits from the Aid to Families with Dependent Children (AFDC) into work, marriage or the Supplemental Security Income (SSI) program are modeled as a function of maternal and child health status. Additionally, several unique variables are included to measure how participants expectations of private health insurance coverage or continued Medicaid coverage affect their decisions to work. In both the demand-side and supply-side analyses, results are estimated using a discrete duration model in which the monthly exit probability is a function of the independent variables of interest, demographic characteristics, and fixed time and county effects. To conduct the analysis, several unique administrative databases on public assistance participation in California from 1987-1995 will be linked. These data were compiled as part of the California Work Pays Demonstration Project. Additionally, data on public assistance participation will be merged with extracts on the availability of health insurance from the Current Population Survey, quarterly Unemployment Insurance (UI) reports in California, known as 202 data, and California's Medicaid payments data. The overall analysis tests several assumptions embedded welfare reform and significantly extends knowledge of the interdependencies between Medicaid and the various public assistance programs that feed into the Medicaid program. The analysis will help improve models of projecting Medicaid expenditures and caseloads and projecting work participation by those on public assistance. Finally, the analysis will help policy- makers simulate how changes in the private health insurance market will affect Medicaid caseloads.

这一分析分为两个相关的组成部分。在第一个组件(称为需求侧分析)从医疗补助计划被建模为当地劳动力市场的函数条件、私人健康保险的可获得性，以及单身母亲对福利的依赖，可获得的数量和质量配偶。针对五组医疗补助开发了不同的模型参与者：(1)单亲家庭，(2)双亲家庭，(3) 失明或残疾儿童，(4)失明或残疾成人，以及(5) 移民。在第二个组件中，称为供应方分析，退出从援助有受扶养子女的家庭(AFDC)到工作，婚姻或补充保障收入(SSI)计划被建模作为孕产妇和儿童健康状况的一项功能。另外，包括了几个独特的变量来衡量参与者如何对私人医疗保险覆盖范围或继续提供医疗补助的期望保险会影响他们的工作决定。在需求方和供应方的分析中，结果都是估计的使用离散持续时间模型，在该模型中，每月退出概率是兴趣、人口统计等自变量的函数特点，以及固定的时间和县效应。为了进行分析，几个独特的管理数据库加州1987-1995年的公共援助参与率将为已链接。这些数据是作为加州工作报酬的一部分汇编的示范项目。此外，关于公共援助的数据参与将与关于健康可获得性的摘录合并来自当前人口调查的保险，季度失业加州的保险(UI)报告，称为202数据，以及加州的医疗补助支付数据。总体分析测试了嵌入福利改革的几个假设并极大地扩展了对医疗补助和各种公共援助计划医疗补助计划。这一分析将有助于改进投射模型医疗补助支出和工作量以及预计的工作参与度由那些接受公共援助的人。最后，分析将有助于政策- 制造商模拟私人健康保险市场的变化将如何影响医疗补助工作量。