The Value of Health Insurance During a Crisis: Effects of Medicaid Implementation on Pandemic Influenza Mortality

44 Pages Posted: 4 May 2020

See all articles by Karen Clay

Karen Clay

Carnegie Mellon University - H. John Heinz III School of Public Policy and Management; National Bureau of Economic Research (NBER)

Joshua Lewis

University of Montreal

Edson Severnini

Carnegie Mellon University

Xiao Wang

Carnegie Mellon University

Multiple version iconThere are 2 versions of this paper

Abstract

This paper studies how better access to public health insurance affects infant mortality during pandemics. Our analysis combines cross-state variation in mandated eligibility for Medicaid with two influenza pandemics — the 1957-58 "Asian Flu" pandemic and the 1968-69 "Hong Kong Flu" — that arrived shortly before and after the program's introduction. Exploiting heterogeneity in the underlying severity of these two shocks across counties, we find no relationship between Medicaid eligibility and pandemic infant mortality during the 1957-58 outbreak. After Medicaid implementation, we find that better access to insurance in high-eligibility states substantially reduced infant mortality during the 1968-69 pandemic. The reductions in pandemic infant mortality are too large to be attributable solely to new Medicaid recipients, suggesting that the expansion in health insurance coverage mitigated disease transmission among the broader population.

Keywords: public health insurance, medicaid, influenza pandemics

JEL Classification: I13, I18, N32, N52

Suggested Citation

Clay, Karen B. and Lewis, Joshua and Severnini, Edson and Wang, Xiao, The Value of Health Insurance During a Crisis: Effects of Medicaid Implementation on Pandemic Influenza Mortality. IZA Discussion Paper No. 13200, Available at SSRN: https://ssrn.com/abstract=3590899 or http://dx.doi.org/10.2139/ssrn.3590899

Karen B. Clay (Contact Author)

Carnegie Mellon University - H. John Heinz III School of Public Policy and Management ( email )

Pittsburgh, PA 15213-3890
United States

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Joshua Lewis

University of Montreal ( email )

C.P. 6128 succursale Centre-ville
Montreal, Quebec H3C 3J7
Canada

Edson Severnini

Carnegie Mellon University

Pittsburgh, PA 15213-3890
United States

Xiao Wang

Carnegie Mellon University ( email )

Pittsburgh, PA 15213-3890
United States

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