When estimating the effects of treatments defined by complex formulas, researchers often use simple functions of exogenous shocks as instruments. A leading example is "simulated instruments" for public policy eligibility, which capture variation in state-level policy generosity. We show how more...

The Affordable Care Act (ACA) significantly expanded health insurance in the United States, but its impact has varied across time and states. We assess the law's heterogeneous impacts over the three presidential administrations since its enactment, as well as across states with different levels...

Hepatitis C is a major public health concern due to its high rates of infection and mortality. Recent breakthroughs in pharmaceuticals not only have the potential to cure hepatitis C but could also cause large positive health externalities through reduced transmission. The high cost of these...

This paper studies two major changes in the financing of Part D drugs for Medicare due to the Inflation Reduction Act (IRA). Effective 2025 it capped out of pocket (OOP) payments at $2000 per year, and effective 2026 it will pay lower prices (negotiated by Medicare) for 10 targeted costly and...

The Affordable Care Act (ACA) changed incentives for individual and employer-sponsored insurance. Using unique small group market (SGM) data with detailed claims and enrollment information, we analyze the welfare gains across households in the SGM from alternative formulations of ACA health...

We examine the causal effect of health insurance on mortality using the universe of low-income adults, a dataset of 37 million individuals identified by linking the 2010 Census to administrative tax data. Our methodology leverages state-level variation in the timing and adoption of Medicaid...

This paper examines the impact of reducing the administrative fragmentation of billing and payment, one commonly cited cause of inefficiency in US health care. We study a Medicare reform that consolidated billing processes across service types, using its staggered rollout and hospitals' prior...

Millions of people lose access to safety-net programs each year because they do not complete the required administrative processes. In a large-scale field experiment, we randomized outreach offering personalized assistance during the Medicaid renewal window to identify the impact of transaction...

Governments and firms often employ soft spending limits to restrict overspending while still allowing exceptions on a case-by-case basis. This paper studies a Medicare policy which capped per-patient physical therapy spending, with exceptions for patients with documented medical need. The cap...

The Medicare Part D program relies on consumer choice to provide insurers with incentives to offer low-priced, high-quality pharmaceutical insurance plans. We demonstrate that consumers switch plans infrequently and search imperfectly. We estimate a model of consumer plan choice with inattentive...