The Implications of Public Policies on Health Economics
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Authors
Katsikas, Aina
Issue Date
2023
Type
Dissertation
Language
Keywords
health economics , healthcare , managed care , Medicaid
Alternative Title
Abstract
This dissertation evaluates the effects of public policies on health insurance coverage, mental health, provider quality and patient health outcomes. The first chapter demonstrates evidence of increased enrollments through the Health Insurance Exchange (HIX) as a result of expanded Premium Tax Credits. I use the variation in state Medicaid expansion statuses to identify the change in HIX enrollments. The second chapter evaluates the effects of the U.S. Supreme Court’s Dobbs vs. Jackson decision in June 2022 on mental health. I leverage the heterogeneity in state abortion restrictions to identify an increase in moderate to severe anxiety symptoms for individuals living in restricted states. I implement a Difference in Difference analysis using a linear probability model and do not find evidence of any pre-trends. Therefore, without the Dobbs’ decision, I would not find an increase in these negative mental health symptoms. The third chapter investigates the impacts of Managed Care on home health provider quality and patient health outcomes. I evaluate Managed Care programs that deliver Long Term Services and Supports (LTSS) for Medicaid beneficiaries. I implement the Callaway Sant’Anna Difference in Difference strategy using panel data at the provider level and find a reduction in overall provider quality. I also find downstream consequences in the form of worsened patient health outcomes. These results may have greater implications in the form of premature admissions to skilled nursing facilities. If patients are unable to receive quality care from home health providers, they may turn to other, more costly, LTSS providers.