Essays on health insurance and the family




Dillender, Marcus Owen

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The three chapters of this dissertation explore the ties among health insurance, changing cultural institution, and labor economics. The first chapter focuses on the relationship between health insurance and wages by taking advantage of states that extended health insurance dependent coverage to young adults before the Patient Protection and Affordable Care Act. Using American Community Survey and Census data, I find evidence that extending health insurance to young adults raises their wages, both while they are eligible for insurance through their parents' employers and afterwards. The increases in wages can be explained by increases in human capital and increased flexibility in the labor market that comes from people no longer having to rely on their own employers for health insurance. The second chapter focuses on understanding the impact of allowing coverage of spouses through employer-sponsored health insurance. The fact that people choose to enter into marriage makes comparing the differences between married and unmarried couples uninformative. To get around this, I examine how shocks to access to insurance through a spouse's employer brought on by extensions in legal recognition have influenced health insurance and labor force decisions for same-sex couples. I find extending legal recognition to same-sex couples results in female same-sex couples being more likely to have one member not in the labor force. The third chapter examines what extending legal recognition to same-sex couples has done to marriage rates in the United States using a strategy that compares how marriage rates change after legal recognition in states that alter legal recognition versus states that do not. Despite claims that allowing same-sex couples to marry will reduce the marriage rate for opposite-sex couples, I find no evidence that allowing same-sex couples to marry reduces the opposite-sex marriage rate. The opposite-sex marriage rate does decrease, however, when domestic partnerships are available to opposite-sex couples.




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