Panel Paper: Decline in Federal Disability Insurance Screening Stringency and Health Insurance Demand

Friday, November 7, 2014 : 10:15 AM
Enchantment Ballroom C (Hyatt)

*Names in bold indicate Presenter

Yue Li, State University of New York, Albany; University at Albany - SUNY and Siying Liu, University of Pittsburgh
The percentage of working-age U.S. residents without health insurance rose substantially over the past few decades. This paper proposes that part of this increase can be attributed to a set of congressional reforms in 1984, which liberalized federal disability insurance screening. We argue that the liberalization increases the probability of receiving disability awards and reduces people's incentives to purchase health insurance when they are healthy. The decrease of health insurance demand is amplified by the increased premiums associated with healthy people opting out of insurance plans. The proposed mechanism has not been explored in the literature. To identify the causal relationship between the liberalization and increased uninsured rates, we exploit the cross-state variation of the initial percentage of residents on disability rolls, a measure of the exposure to the 1984 reforms. Results suggest that the more exposed states experienced larger increases in local uninsured rates after the liberalization: comparing two states over the period of 1985 through 1994, one at the 25th percentile and the other at the 75th percentile, the more exposed state would experience a differential 0.7 percentage point increase in uninsured rates. Most of the observed adjustment is associated with the declining demand for individual health insurance.

Full Paper: