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Biosketch:
Dr. Lo Sasso is an economist and applied econometrician whose research
spans several dimensions of health and labor economics and health services
research. He is currently in the final year of a 5-year Independent Scientist
Award from the Agency for Healthcare Research and Quality studying workplace
health benefits and how they affect employee health. As part of this broad
research agenda, Dr. Lo Sasso has recently completed a study funded by
the National Institute of Mental Health to examine the impact of an expansion
of mental health benefits on cost and quality of care at a Fortune 50
manufacturing firm. In addition, Dr. Lo Sasso is currently studying the
nascent consumer-driven health care movement and its potential impact
on employer-sponsored health insurance and employee health. Other recent
research has examined the effect of copayment levels on the use of employer-provided
substance abuse benefits. Additionally, he has explored the extent of
so-called “responsible purchasing” by employers: the degree
to which employers collect and use non-financial information in selecting
and managing employee health care plans. Dr. Lo Sasso is also keenly interested
in how government policies affect private sector decisions. He has studied
the impact of the State Children’s Health Insurance Program on uninsurance
among children and the extent to which public coverage may have “crowded
out” private coverage of children. He currently has a grant to study
how community rating provisions in state non-group health insurance markets
affect non-group health insurance coverage and uninsurance. Dr. Lo Sasso
also has recently completed a project funded by the Robert Wood Johnson
Foundation’s Changes in Health Care Financing and Organization initiative
to study how the availability of safety net health care services affects
the willingness of firms to offer health insurance and the willingness
of employees to take-up health insurance when it is offered.
Abstract:
There is an extensive literature on the extent to which public health
insurance coverage through Medicaid induces less private health insurance
coverage. However, little is known about the effect of other components
of the health care safety net in crowding out private coverage. We examine
the effect of Medicaid and uncompensated care provided by clinics and
hospitals on insurance coverage. We construct a long panel of state-level
data on hospital uncompensated care and free and reduced price care offered
by Federally Qualified Health Centers. We match this information to individual
level data on coverage from the Current Population Survey for two distinct
groups: children aged 14 and under and single, childless adults aged 18
to 64. Our results provide mixed evidence on the extent of crowd-out.
Hospital uncompensated care does not appear to crowd-out health insurance
coverage and health center uncompensated care appears to crowd-out private
coverage for adults and, in some specifications, children.
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