Essays in Labor and Health Economics

Abstract

Chapter 1 investigates the impact of the opioid crisis on the foster care system, motivated by a growing literature suggesting that the opioid crisis has negatively impacted children. This paper builds on prior work by separately identifying the causal effects of parental illicit opioid use and prescription opioid (PO) misuse on foster care entry and caseload after 2010. Two baseline opioid supply measures from 2000, at the onset of the opioid crisis, instrument for post-2010 changes in opioid overdose death rates among adults of prime parenting age. Using county-level mortality data and administrative foster care records, I find that moving from the 10th to the 90th percentile of change in the illicit opioid death rate leads to a 1.1 (2.4) standard deviations larger percent growth in foster care entry (caseload). In contrast, a 10th to 90th percentile difference in the change in PO misuse does not significantly affect total entry or caseload. Female illicit opioid use has larger effects than male illicit opioid use. Effects are similar across child age at the time of removal. Illicit opioid use has similar effects across all placement settings, whereas PO misuse only increases entry to kinship care.

Chapter 2 studies how an expansion of public health insurance affects self-employment dynamics. I investigate this question in the context of the Affordable Care Act (ACA) Medicaid expansion, which made Medicaid available to all non-elderly adults with family income up to 138% of the federal poverty level. By increasing access to health insurance outside of wage employment, expanding Medicaid eligibility could (i) induce some wage workers to become self-employed, and (ii) increase persistence in self-employment for the currently self-employed. Using the 2003-2016 CPS-ASEC linked to respondents' earnings histories from tax returns, I estimate the effect of expanding Medicaid eligibility on the probability of self-employment, wage employment to self-employment transition, and self-employment persistence among childless adults, the group that saw the largest increase in Medicaid eligibility as a result of the expansion. Using difference-in-differences that takes into account pre-ACA cross-county variation in population shares of "at-risk" groups and triple differences, I find suggestive evidence that the expansion of Medicaid eligibility may have increased persistence in self-employment for those with a relatively high valuation of health insurance, but no effects on wage employment to self-employment transitions or self-employment rates.

Chapter 3 (with Katharine Abraham, John Haltiwanger, Kristin Sandusky, and James Spletzer) examines the role of self-employment in older workers' transitions to retirement. Self-employment rates rise with age, especially past the age of 50. Using unique integrated survey and administrative data, we find the share of the employed who are primarily self-employed more than doubles from age 47-52 to 65-70 – rising from under 10% to more than 20%. This growth reflects the differential patterns by age of all of the transitions among wage and salary employment, self-employment and non-employment. There is a sharp decline in the likelihood that workers switch from self-employment to wage and salary employment with age, but not the reverse. The share of wage and salary workers who transition to non-employment each year rises more rapidly with age between 53-58 and 65-70 than is the case for the self-employed. Just as important, there is a much sharper decline with age in the pace of transitions from non-employment to wage and salary employment than in the pace of transitions from non-employment to self-employment. The interaction of these changing transition rates, as opposed to simply their individual effects, plays a large role in accounting for the increase in the self-employment rate with age. We investigate how education, cumulative earnings over the prior 20 years, and earnings volatility over the prior 20 years affect these changing transition dynamics by age. We find, for example, that wage and salary workers who are more educated and have higher cumulative earnings are more likely to move to self-employment and less likely to move to non-employment, with both of these effects larger at older ages.