Medicaid and the Children’s Health Insurance Program (CHIP) are key supports for pregnant women and new mothers,1 as well as their children in the critical early years of life. Medicaid pays for nearly half of all births in the United States, including a greater share of births in rural areas, among young women, and women of color.2 Medicaid and CHIP also cover close to half of the nation’s children under age 3, making it the largest source of coverage for infants and toddlers.3 Federal minimum standards and state expansions have created public health coverage pathways that give millions of women improved access to essential prenatal, birth-related, and postpartum care. But more can be done to ensure that Medicaid and CHIP coverage for pregnant women provides affordable, comprehensive care that supports optimal pregnancy outcomes for mothers and babies, and helps build the foundation for a strong, nurturing relationship between mother and child. This brief describes the existing Medicaid and CHIP eligibility pathways for pregnant women and outlines federal minimum standards and state options to expand coverage to more pregnant women and opportunities to better align maternal and infant health coverage.

We study the dynamics of participation and health care consumption in the Affordable Care Act's health insurance marketplaces. Unlike other health insurance contexts, we find individuals commonly drop coverage midyear-roughly 30% of enrollees exit within nine months of sign-up. While covered, dropouts spend more on health care than in the months before sign-up or after exit. We model the consequences of drop-out on equilibrium premiums and consumer welfare. While dropouts generate a type of adverse selection, the welfare effect from their participation is ambiguous and depends on the relative costs per month of part-year vs. full-year enrollees. In our empirical setting, we find that imposing a penalty that incentivizes participation for at least 3.5 months would lower premium levels and improve overall consumer welfare.

There is growing evidence of risks associated with excessive technology use, especially among teens and young adults. However, little is known about the characteristics of those who are at elevated risk of being problematic users. Using data from the 2012 Current Population Survey Internet Use Supplement and Educational Supplement for teens and young adults, this study developed a conceptual framework for modeling technology use. A three-part categorization of use was posited for utilitarian, social and entertainment purposes, which fit observed data well in confirmatory factor analysis. Seemingly unrelated regression was used to examine the demographic characteristics associated with each of the three categories of use. Exploratory factor analysis uncovered five distinct types of users, including one user type that was hypothesized to likely be at elevated risk of problematic use. Regression results indicated that females in their twenties who are in school and have greater access to technology were most likely to fall into this higher-risk category. Young people who live with both parents were less likely to belong to this category. This study highlighted the importance of constructing models that facilitate identification of patterns of use that may characterize a subset of users at high risk of problematic use. The findings can be applied to other contexts to inform policies related to technology and society as well.

Prospective, population-based surveillance to systematically ascertain exposures to food production animals or their environments among Minnesota residents with sporadic, domestically acquired, laboratory-confirmed enteric zoonotic pathogen infections was conducted from 2012 through 2016. Twenty-three percent ( n = 1708) of the 7560 enteric disease cases in the study reported an animal agriculture exposure in their incubation period, including 60% (344/571) of Cryptosporidium parvum cases, 28% (934/3391) of Campylobacter cases, 22% (85/383) of Shiga toxin-producing Escherichia coli (STEC) O157 cases, 16% (83/521) of non-O157 STEC cases, 10% (253/2575) of non-typhoidal Salmonella enterica cases and 8% (9/119) of Yersinia enterocolitica cases. Living and/or working on a farm accounted for 61% of cases with an agricultural exposure, followed by visiting a private farm (29% of cases) and visiting a public animal agriculture venue (10% of cases). Cattle were the most common animal type in agricultural exposures, reported by 72% of cases. The estimated cumulative incidence of zoonotic enteric infections for people who live and/or work on farms with food production animals in Minnesota during 2012–2016 was 147 per 10 000 population, vs. 18.5 per 10 000 for other Minnesotans. The burden of enteric zoonoses among people with animal agriculture exposures appears to be far greater than previously appreciated.

Identifying essential and frontline workers and understanding their characteristics is useful for policymakers and researchers in targeting social insurance and safety net policies in response to the COVID-19 crisis. We develop a working definition that may inform additional research and policy discussion and provide data on the demographic and labor market composition of these workers. In a three-step approach, we first apply the official industry guidelines issued by the Department of Homeland Security (DHS) to microdata from the 2017 and 2018 American Community Survey to identify essential workers regardless of actual operation status of their industry. We then use data on the feasibility of work from home in the worker’s occupation group (Dingel and Neiman 2020) to identify those most likely to be frontline workers who worked in-person early in the COVID-19 crisis in March/ April 2020. In a third step we exclude industries that were shutdown or running under limited demand at that time (Vavra, 2020). We find that the broader group of essential workers comprises a large share of the labor force and tends to mirror its demographic and labor market characteristics. In contrast, the narrower category of frontline workers is, on average, less educated, has lower wages, and has a higher representation of men, disadvantaged minorities, especially Hispanics, and immigrants. These results hold even when excluding industries that were shutdown or operating at a limited level.

California is known for home values that eclipse U.S. housing prices. To increase housing inventory, California has implemented a regional housing needs allocation (RHNA) to transmit shares of housing growth to cities. However, no study has established RHNA’s efficacy. After examining the 4th RHNA cycle (i.e., 2006–2014) for 185 Los Angeles region cities, this study determined that RHNA directed housing growth to the city of Los Angeles and the region’s outlying cities as opposed to increasing density in the central and coastal cities. Second, RHNA directed 62% of housing growth to the region’s unaffordable cities. Third, the sample suffered a 34% shortfall in housing growth due to the Great Recession but garnered an average achievement of approximately 93% due to RHNA’s transmission of minimal housing growth shares. Lastly, RHNA maintained statistically significant associations with increased housing inventory, housing affordability, and housing growth rates, indicating that RHNA may influence housing development.

Why do individuals join interest groups? Through what channels do interest groups and public policy affect one another? We study these questions by analyzing the interplay among labor unions, minimum wages, news coverage, and public opinion. Over the past decade, labor unions have played a significant role in advocating for state and federal minimum wage increases. Over this period, we find that each dollar in minimum wage increase predicts a 5 percent increase (0.3 pp) in the union membership rate among individuals age 16–40. We document four additional facts that shed light on the mechanisms that may underlie this finding. First, while we find increases overall in union membership, we find declines among the minimum wage’s most direct beneficiaries. This is consistent with a classic “free-riding” hypothesis. Second, we find increases in union membership among much broader groups that are not directly affected by the minimum wage. Third, we find that minimum wage increases predict increases in unions’ favorability ratings among the public. Fourth, we find that events in the legislative histories of minimum wage increases predict increases in counts of newspaper articles that simultaneously discuss the minimum wage and key players in the labor movement. Overall coverage of organized labor shifts towards articles that discuss the minimum wage. These facts are consistent with models in which a desire to affiliate with “effective advocacy” is an important driver of the decision to participate in unions and other politically oriented groups.

Despite overall reductions in U.S. smoking prevalence, prior evidence suggests similar reductions may not have occurred for menthol cigarette users. This study examines nationally representative current menthol and non-menthol cigarette use prevalence and trends for adults (18+) overall and by sociodemographic and geographic characteristics using the 2005 (n = 31,132), 2010 (n = 26,967), and 2015 (n = 33,541) National Health Interview Survey. Between 2005 and 2015, non-menthol cigarette use decreased overall (14.7% to 9.6%, p < 0.001) and within all sociodemographic and geographic subgroups analyzed (i.e., by sex, age, race/ethnicity, sexual orientation, education, family income, and geographic region), except non-Hispanic American Indians/Alaskan Natives (NH AI/AN) and non-Hispanic Others. Menthol cigarette use significantly decreased overall (5.3% to 4.4%, p < 0.001), and among females (5.6% to 4.6%); participants aged 18–24 (7.1% to 4.3%) and 35–54 (6.2% to 4.9%); non-Hispanic Whites (4.1% to 3.6%) and non-Hispanic Blacks (14.8% to 11.9%); participants with high school degrees/GEDs (7.0% to 5.9%); participants with a family income of $75,000 or higher (3.4% to 2.3%); and participants residing in the Northeast (6.0% to 4.3%). Menthol cigarette use remained stable or did not significantly decrease among males; adults aged 25–34 and 55 years and older; NH AI/ANs, NH Others, and Hispanics; participants with less than high school education, some college, or a college degree; participants with a family income below $75,000; and participants residing in the North Central/Midwest, South, and West. Given that menthol cigarette use did not significantly change or decrease for multiple subgroups, further restriction on menthol manufacturing may help reduce tobacco use disparities.

Becker (1973) presents a bilateral matching model in which scalar types describe agents. For this framework , he establishes the conditions under which positive sorting between agents' attributes is the unique market outcome. Becker's celebrated sorting result has been applied to address many economic questions. However, recent empirical studies in the fields of health, household, and labor economics suggest that agents have multiple outcome-relevant attributes. In this paper, I study a matching model with multidimensional types. I offer multidimensional generalizations of concordance and supermodularity to construct three multidimensional sorting patterns and two classes of multidimensional complementarities. For each of these sorting patterns, I identify the sufficient conditions which guarantee its optimality. In practice, we observe sorting patterns between observed attributes that are aggregated over unobserved characteristics. To reconcile theory with practice, I establish the link between production complemen-tarities and the aggregated sorting patterns. Finally, I examine the relationship between agents' health status and their spouses' education levels among U.S. households within the framework for multidimen-sional matching markets. Preliminary analysis reveals a weak positive association between agents' health status and their spouses' education levels. This weak positive association is estimated to be a product of three factors: (a) an attraction between better-educated individuals, (b) an attraction between healthier individuals, and (c) a weak positive association between agents' health status and their education levels. The attraction channel suggests that the insurance risk associated with a two-person family plan is higher than the aggregate risk associated with two individual policies.

At a time of heightened anxiety surrounding immigration, state governments have increasingly sought to manage immigrant and refugee flows. Yet the factors that influence where immigrants choose to settle after arrival remain unclear. We bring evidence to this question by analyzing population-level data for refugees resettled within the United States. Unlike other immigrants, refugees are assigned to initial locations across the country but are free to relocate and select another residence after arrival. Drawing on individual-level administrative data for adult refugees resettled between 2000 and 2014 (N = 447,747), we examine the relative desirability of locations by examining how retention rates and patterns of secondary migration differ across states. We find no discernible evidence that refugees’ locational choices are strongly influenced by state partisanship or the generosity of welfare benefits. Instead, we find that refugees prioritize locations with employment opportunities and existing co-national networks.

Importance Millions of low-income children in the United States reside in substandard or unaffordable housing. Relieving these burdens may be associated with changes in asthma outcomes. Objectives To examine whether participation in the US Department of Housing and Urban Development’s (HUD) rental assistance programs is associated with childhood asthma outcomes and to examine whether associations varied by program type (public housing, multifamily housing, or housing choice vouchers). Design, Setting, and Participants This survey study used data from the nationally representative National Health Interview Survey linked to administrative housing assistance records from January 1, 1999, to December 31, 2014. A total of 2992 children aged 0 to 17 years who were currently receiving rental assistance or would enter a rental assistance program within 2 years of survey interview were included. Data analysis was performed from January 15, 2018, to August 31, 2019. Exposures Participation in rental assistance provided by HUD. Main Outcomes and Measures Ever been diagnosed with asthma, 12-month history of asthma attack, and 12-month history of visiting an emergency department for the treatment of asthma among program participants vs those waiting to enter a program. Overall participation was examined, and participation in public or multifamily housing was compared with participation in housing choice vouchers. Results This study included 2992 children who were currently participating in a HUD program or would enter a program within 2 years. Among children with an asthma attack in the past year, participation in a rental assistance program was associated with a reduced use of emergency departments for asthma of 18.2 percentage points (95% CI, −29.7 to −6.6 percentage points). Associations were only found after entrance into a program, suggesting that they were not confounded by time-varying factors. Statistically significant results were found for participation in public or multifamily housing (percentage point change, −36.6; 95% CI, −54.8 to −18.4) but not housing choice vouchers (percentage point change, −7.2; 95% CI, −24.6 to 10.3). No statistically significant evidence of changes in asthma attacks was found (percentage point change, −2.7; 95% CI, −12.3 to 7.0 percentage points). Results for asthma diagnosis were smaller and only significant at the 10% level (−4.3; 95% CI, −8.8 to 0.2 percentage points). Conclusions and Relevance Among children with a recent asthma attack, rental assistance was associated with less emergency department use. These results may have important implications for the well-being of low-income families and health care system costs.

This report provides evidence on the rent, mortgage, and student loan payment patterns from the second quarter of 2020, using innovative new household survey data from the Understanding America Survey (UAS), an internet panel survey of over 8,000 households fielded every two weeks and specially tailored to study the impact of the coronavirus. It provides close to real-time economic data on the rapidly evolving financial consequences of the pandemic.

Objective: The objective if this study was to directly assess the contamination and fragmentation of parents' leisure quality with direct measures of experienced well-being. Background: Parents report less leisure than those without children, and the nature of their leisure differs in ways that are assumed to reflect lower quality—contaminated by the presence of children or fragmented by care work or other demands. Previous research on this question has not been able to assess leisure quality directly. Method: Using the 2010, 2012, and 2013 American Time Use Survey's Well-Being Module (N = 5,433 parents; N = 7,066 activities) and random intercept models to account for multilevel data, the authors investigated mothers' and fathers' reports of well-being across multiple dimensions in leisure activities and directly assessed their experiences in leisure activities (a) with children present or (b) interrupted by care work or other demands. Results: Contrary to expectations from prior work, there was no evidence that leisure was of lower quality with children, and leisure interruptions had little bearing on parents' well-being. Well-being was especially high in “family time” with both children and other adults. Conclusion: Leisure time with children, considered of lower quality in prior accounts, was not experienced more negatively by parents. These findings suggest a reconsideration of how we think about and measure the quality of leisure time.

Research on occupational licensing suggests that licenses reduce labor supply and generate a wage premium. Rather than effects on one's own occupation, I test for the presence of wage spillovers onto other occupations with similar latent skills. Using data from O*NET, I cluster occupations together using Hierarchical Agglomerative Clustering. Leveraging cross-state variation in individual licensing status from the CPS, and using a border discontinuity design on individual ACS microdata, I estimate the labor market spillovers of licenses onto other occupations. I find that a 10 percentage point increase in licensure rates in related occupations reduces individual earnings in one's own occupation by approximately 2-2.5%. These effects are particularly strong for women, Non-Hispanic black, and foreign-born Hispanic workers. Licensing spillovers shift the composition of workers in related occupations. Contrary to a standard labor supply prediction, overall employment falls in related occupations. Falling earnings combined with falling employment are more in line with the predictions of a monopsony model where licensing reduces the feasibility of outside options and increases search costs.

Childlessness, Number of Children and The Labor Market at the Time of a New Technology, the US 1980-2018 The adoption of a new computer-based technology in the US in the late 1970s resulted in broad changes on the labor market that can be described by two major phenomena - job polarization and a shift in the relative returns to skill. A well established theoretical and empirical literature shows that commuting zones with a historically greater specialization in routine task intensive occupations adopted the new computer-based technology faster and subsequently saw greater changes on the local labor markets. In this paper, I build on the previous literature and analyze the relationship between the historical specialization of commuting zones in routine task intensive occupations and the change in family fertility outcomes in the US 1980-2018. The prediction is that commuting zones with a greater initial routine task specialization adopted the new technology faster and thereafter saw greater changes on the local labor markets, which further led to greater changes in the fertility outcomes. The estimation results suggest that among women in the age group 20-39 of any educational level, the shares of women with at least one child and at least two children decreased by more in commuting zones with a historically greater routine task employment. The result is driven by college educated women. Marital economic homogamy and earnings polarization, the US 1970-2018 In this paper I analyze what impact the polarization of earnings had on a rise in the economic resemblance between marriage partners aged 27-36 in the US 1970-2018. An earnings polarization means that the relative earnings gap at the upper end of the earnings distribution has been widening, while the relative earnings gap at the lower end of the earnings distribution has been narrowing in the US since the 1950s-1960s. I employ a structural change driven explanation of labor market polarization and the instrumental variable technique to identify the causal effect of interest. The estimation results show that the marital economic resemblance increases on the widening relative earnings gap at the upper/lower part of the earnings distribution and decreases on the narrowing relative earnings gap at the upper/lower part of the earnings distribution. Keeping all else equal, the polarization of earnings would account for 19 to 25 percent of the rise in the coefficient of marital sorting in the US between 1970 and 2018. New Careers, Labor Market Turmoil and Gender: Evidence from Russia 2000-2016 In this paper I study what was the effect of entering the labor market under adverse economic conditions on the career development of college educated men and women in Russia 2000-2016. The instrumental variable technique is used to identify the causal effect of interest. I find a negative immediate effect of graduating in a bad economy on the log hourly wage among all college graduates and among college graduate men. Although the negative effect gradually dissipates as the economy picks up, it remains present years after graduation. When it comes to college women, no immediate effect of graduating in a bad economy on the hourly wage is identified. The negative effect on the hourly wage among women first pops up three to five years after graduation. College men and women who graduated in a bad economy do, on average, have lower quality jobs which might explain negatively affected hourly wages.

This paper studies the effects of recessions on U.S. local labor markets. Using variation in sudden employment losses during each recession between 1973 and 2009, we find that areas more affected by recessions experience highly persistent declines in employment and population. Most importantly, and contrary to prior work, every recession we study generates local labor market hysteresis in the form of persistent decreases in the employment-population ratio and earnings per capita. Our results imply that recessions induce persistent reallocation of employment across space, and that limited population responses result in longer-lasting disruptions to local labor markets than previously thought.

Recent research shows that increasing the minimum wage does not result in significant job losses. Yet, there is still uncertainty as to how higher labor standards may reshape employment practices within firms. This article directly examines employer responses to higher labor standards through a qualitative case comparison of the full-service restaurant industry across two fundamentally different institutional settings: San Francisco—with the nation’s highest minimum wage and related mandates—and North Carolina’s Research Triangle region. Evidence shows that higher labor standards led to wage compression even while some employers offered higher benefits to reduce turnover. San Francisco employers seek higher-skilled, more professional workers, rather than invest in formal in-house training, and find better matches. Yet, higher-wage mandates have exacerbated the wage gap between occupations, and some employers have responded by radically restructuring industry compensation practices by adding service charges and eliminating tipping.

This paper studies individuals’ possible choice to forgo their ancestral ethnicity and adopt a specific new ethnicity. We first use individual-level panel data for Indonesia as well as other countries (e.g., the U.S.) to document the pervasiveness of intra-individual ethnicity change and its coincidence with major life events, particularly, interethnic marriage. Next, we focus on individuals who have intermarried and exploit variation in deep-rooted community-level norms on matrilocality (co-residence with the wife’s family) to identify how differences in expected costs and benefits of ethnicity change causally affect newlyweds’ choice to adopt a specific ethnicity (i.e., their spouses’ ethnicity) or not. Results obtained using a three-wave panel comprising more than 13,000 Indonesians confirm the expected effect of matrilocality, as newly intermarried men (women) are significantly more (less) likely to adopt their spouses’ ethnicity when the couple lives in a matrilocal community compared to a non-matrilocal one. Because ethnicity change is a means to fit in, important implication of our findings is that in many countries key statistics on ethnic fractionalization and segregation are severely inflated.

The Chinese Exclusion Act of 1882 banned Chinese immigration and institutionalized discrimination against Chinese in U.S. society. This study examines the impact of institutional discrimination on the assimilation of Chinese by exploiting the passage of the Act and the state-level variation in the intensity of discrimination, measured by the voting outcomes of the Act and the number of anti-Chinese incidents. Our difference-indifferences estimates show that discrimination substantially slowed the occupational assimilation of Chinese in the Exclusion Era (1882-1943) and that Chinese in the U.S. reacted to discrimination by investing in human capital, improving English skills, and increasingly adopting Americanized names. The triple difference estimates show that these effects are significantly stronger in states with higher support rates of the Act or greater numbers of anti-Chinese incidents. These findings are not driven by the selection in migration and fertility.

Telephone operation, one of the most common jobs for young American women in the early 1900s, provided hundreds of thousands of female workers a pathway into the labor force. Between 1920 and 1940, AT&T adopted mechanical switching technology in more than half of the U.S. telephone network, replacing manual operation. Although automation eliminated most of these jobs, it did not affect future cohorts’ overall employment: the decline in demand for operators was counteracted by growth in both middle-skill jobs like secretarial work and lowerwage service jobs, which absorbed future generations. Using a new genealogy-based census linking method, we show that incumbent telephone operators were most impacted by automation, and a decade later were more likely to be in lower-paying occupations or have left the labor force entirely.