1. Impacts of Covid 19 on the US Economy Essay
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EssayRequirements:Introduction: In the 4–5 Pages introduction you will state your
research question clearly on the first page. But you need to do much more than that. You
will first motivate your question –why is it important? Who would benefit from knowing the
answer? Why does the answer to question matter? You will also provide important
background information about your topic.Readers may need some statistics to understand
your topic (e.g., the size ofU.S. government debt and how has it grown/shrunk over the
past 20years), or they may need to understand how a particular policy works (e.g., how the
European Union’s carbon taxis structured).TOPIC: How has the COVID-19 pandemic
affected U.S. industries differentially? How much of this economic effect can be attributed to
lockdown orders vs. fear of the virus? Will these effects persist into the future? What is the
impact of the epidemic on food（supermarket, grocery store)?be double spaced with 12-
point fonthave margins no larger than 1” on top and bottom and 1 ½’’ on the sides. If your
margins are larger, I will remove points for not meeting the length requirement for the
paper.(except for responses to prompts) have a cover page.Impacts of Covid 19 on the US
Economy Essayattachment_1attachment_2Unformatted Attachment PreviewReferences
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Introduction Promoting child health insurance coverage has been a policy priority in the
United States over the course of the past 20 years. Given concern over child health
outcomes, particularly infant mortality, federal and state governments bolstered their
commitments to the Medicaid program starting in the late 1980s. Most recently, the State
Children’s Health Insurance Program (SCHIP) was created in 1997 to expand public
insurance eligibility to children in families with incomes beyond Medicaid eligibility levels.
SCHIP has now been operating in all states for ten years and has recently been re-
authorized by Congress. Recent economic research indicates that childhood health can have
a lasting impact on both health and economic status in adulthood (see, for example, Case et
4. al. 2006 and Smith 2009). According to this argument, health investments made early in life
are likely to be beneficial in promoting human capital investment and lowering lifelong
medical expenditures. Additionally, children are likely to benefit more immediately from
increased access to health care through channels such as increased immunization rates.
Therefore, investments in child health may be a particularly cost effective form of public
expenditure from a long run point of view. Our goal in this paper is to analyze the effect of
SCHIP expansions in public health insurance for children on overall rates of insurance
coverage and several measures of poor health. (Note: this is our research question) Over the
past two decades there has been an enormous increase in federal and state commitment to
promote public health insurance coverage for children. Medicaid has been the primary
means of financing health care services for poor children in the United States since its
inception in 1965. Initially, Medicaid covered only children in families meeting the income
and categorical eligibility requirements of the Aid to Families with Dependent Children
(AFDC) 1 program. Starting with the Omnibus Budget Reconciliation Act (OBRA) of 1986, a
series of federal laws established Medicaid eligibility standards for children not eligible for
AFDC by first removing categorical eligibility requirements and then increasing the fraction
of the federal poverty level at which children were eligible based upon their families’
incomes. Following the federal expansions, many states expanded eligibility for their
Medicaid programs even further to include children not covered by the federal mandates.
Table 1 summarizes the resulting average state Medicaid eligibility thresholds (measured
by family income as a percentage of the federal poverty line) in 1997, broken down by child
age. Because younger children were the primary targets of early Medicaid expansions, the
average eligibility threshold is a negative function of age, with the average infant being
eligible for Medicaid at a family income of up to approximately 175 percent of the federal
poverty line and the average 15 to 18 year old eligible at a family income less than or equal
to the poverty line. Despite the Medicaid expansions, enrollment in Medicaid fell and the
number of uninsured children rose slightly during the early to mid-1990s. Impacts of Covid
19 on the US Economy EssayWelfare reform and decreasing availability of employer-
sponsored insurance are both likely to have contributed to these trends. For example, Joyce
and Racine (2005) find some evidence that TANF resulted in a loss of Medicaid coverage for
women and children whose cash assistance ended. In response to declining enrollment and
the increasing number of uninsured children in working poor families, the Balanced Budget
Act (BBA) of 1997 was signed into law in August 1997. BBA97, under Title XXI of the Social
Security Act, provided states with $40 billion over ten years in block grant funding to
further expand publicly-provided health insurance for children. The Act gave states a great
deal of flexibility in how far and how fast they expanded coverage. For example, states could
use the new grant money to expand Medicaid, develop a new program or expand an 2
existing state program that provided health insurance for children, or use a combination of
the two approaches as long as the funds were used to serve children below age nineteen
who are living in families with incomes that were either at or below 200 percent of the
federal poverty level or 50 percentage points above the Medicaid income eligibility in effect
in March 1997. Consequently, there existed wide variation in states’ responses to the
changes enacted by BBA97 in terms of magnitude, timing, and form. Each of the 50 states
5. and the District of Columbia had an approved SCHIP plan in place by 2000. While eleven
states enacted their program during the final months 1997, the majority (33 states and the
District of Columbia) did so in 1998, and the remaining 6 states implemented it in 1999 or
2000. States also vary in the structure of their SCHIP programs. Sixteen states expanded
Medicaid, 14 states and the District of Columbia created a separate SCHIP program, and 20
states developed a combination program. Appendix Table 2 summarizes the timing of SCHIP
implementation, types of SCHIP programs, and income eligibility variation across states and
age groups. As shown in Figure 1, average eligibility levels of children for public health
insurance under SCHIP increased for children in every age group between 1997 and 2002.
Given the fact that the previous series of Medicaid expansions targeted younger children,
generally speaking, the magnitude of income eligibility increases under SCHIP is much
bigger for older children than for younger children. By increasing income limits for older
children more than for younger children, the SCHIP expansions largely eliminated this
within-state age variation in eligibility. For example, over the period from 1997 to 2002, the
average income eligibility (measured as a fraction of the federal poverty line) increased by
27 percentage points for infants and by 115 percentage points for children aged 14 or older.
We will exploit this differential eligibility 3 expansion by child age, along with expansion
differences across states, in order to identify the causal impact of SCHIP on health insurance
coverage, utilization of preventive care and health status. While changes in health insurance
coverage patterns attributable to SCHIP have been fairly well documented, there has been
less analysis of the utilization and, in particular, the health effects of the program. The goal
of this paper is to examine the impact of SCHIP on utilization of primary care services and
health outcomes for children using data from the National Survey of America’s Families
(NSAF). Policies like SCHIP are designed to increase the number of children eligible for
health insurance, with the hope that such an eligibility expansion will further lead to an
increase in medical care utilization and finally translate into an improvement in child health
outcomes. However, studies of the relationships between eligibility and coverage may
provide only partial information, since coverage may not automatically translate into
improved access to medical care or better health outcomes. On the other hand, studies that
look directly at the relationship between eligibility changes and health outcome may find
little or no improvement in outcomes. In this case, small health impacts could result from
either low enrollment in available insurance, problems with access to care for newly
insured children or the fact that the care being utilized does not effectively improve health.
Impacts of Covid 19 on the US Economy EssayAs Gruber (2003) points out, in order for an
eligibility expansion to translate into better health, three things must happen: (1) eligible
children must be enrolled a SCHIP plan; (2) covered children (or their parents) must have
and make use of low-cost access to medical care and (3) the care received must improve
health. If any of these links are broken, then generous eligibility expansions in child health
insurance will not noticeably affect health outcomes. Eisenberg and Power (2000) discuss
the potential missing 4 links between health insurance coverage and high-quality medical
care in detail and refer to them as “voltage drops.” Therefore, in order to appropriately
analyze the health effects of the policy, one would need separate information on the
relationships between SCHIP eligibility and health insurance coverage, access medical care
6. and health status. Our analysis of NSAF data will allow us to do this. The paper proceeds as
follows. In the next section we present a theoretical model that generates predictions about
the relationship between health insurance coverage and health status. After that is a review
of the economics literature on public health insurance programs for children, insurance
coverage and health outcomes. Finally, we discuss the results of our own original data
analysis. 5 References Case, Anne, Angela Fertig and Christina Paxson. 2006. The Lasting
Impact of Childhood Health and Circumstance. Journal of Health Economics 24(2): 365-389.
Eisenberg J. and E. Power. 2000. Transforming Insurance Coverage into Quality Health Care:
Voltage Drops from Potential to Delivered Quality. Journal of the American Medical
Association 284: 2100-2107. Gruber, Jonathan. 2003. “Medicaid” in Means Tested Transfer
Programs in the United States, Robert A. Moffitt, ed. Chicago: University of Chicago Press.
Smith, James P. 2009. The Impact of Childhood Health on Adult Labor Market Outcomes.
Review of Economics and Statistics 91(3): 478-489. 6 Figure 1 Medicaid/SCHIP Income
Eligibility as % Federal Poverty Line 250 200 1997 Medicaid 150 2002 SCHIP 100 50 0
Infant 1-5 6-14 Age Group 15+ Source: National Governors Association. MCH Updates (2000
and 2002). Data collected by the NGA Center for Best Practices. 7 Appendix Table 2:
Summary of SCHIP Programs by State State Type AK AL AR AZ CA CO CT DC DE FL GA HI IA
ID IL IN KS KY LA MA MD ME MI MN MO COMB M S M COMB S COMB S M COMB S M M
COMB COMB COMB S M COMB COMB COMB COMB COMB M COMB Date implemented Mar-
99 Feb-98 Oct-98 Oct-97 Mar-98 Apr-98 Jul-97 Oct-98 Oct-98 Apr-98 Sep-98 Jan-00 Sep-98
Oct-97 Jan-98 Oct-97 Jul-98 Jul-98 Nov-98 Oct-97 Jul-98 Aug-98 May-98 Sep-98 Oct-97 Ages
1-5 Eligibility Cutoff 1997 2002 Age 15+ Eligibility Cutoff 1997 2002 133 133 133 200 133
133 185 133 133 133 133 133 133 133 133 133 133 133 133 133 185 133 150 275 133 15
76 32 200 82 39 185 100 50 28 0 100 29 46 100 39 100 30 100 125 34 133 150 275 34
200% 200 200 200 250 185 300 200 200 200 235 200 150 185 200 200 200 200 200 200
300 200 200 280 200 200% 200 200 200 250 185 300 200 200 200 235 200 150 185 200
200 200 200 200 200 300 200 200 275 200 State Type Date Implemented MS MT NC ND NE
NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY M S M S COMB
COMB M COMB S COMB M M S S M M COMB M COMB S S COMB S S M S Mar-97 Jan-98 Oct-
98 Oct-98 May-98 May-98 Feb-98 Mar-99 Oct-98 Apr-98 Jan-98 Dec-97 Sep-98 Jun-98 Oct-
97 Aug-97 Jul-98 Oct-97 Jul-98 Aug-98 Oct-98 Oct-98 Jan-00 Apr-99 Jul-98 Apr-99 Ages 1-5
Eligibility Cutoff 1997 2002 Age 15+ Eligibility Cutoff 1997 2002 133 133 133 133 185 133
185 133 133 133 133 133 133 133 250 150 133 400 133 133 225 133 200 133 185 133
100 41 34 45 185 41 185 87 100 100 32 48 100 100 250 150 100 400 17 100 225 100 200
100 62 55 300 150 185 200 300 350 235 250 200 140 200 185 170 235 250 150 200 200
200 200 300 200 250 200 200 133 300 150 185 200 300 350 235 250 200 140 200 185
170 235 250 150 200 200 200 200 300 200 250 200 200 133 Source: National Governors
Association, Maternal and Child Health Update, various years. Notes: States over-sampled in
the NSAF are highlighted. M = expanded Medicaid program; S = new SCHIP program; COMB
= combined Medicaid/SCHIP programs. 8 -9Impacts of Covid 19 on the US Economy Essay
