The Effect of Public Insurance Design on Pharmaceutical Prices: Evidence From Medicare Part D
(with Katja Hofmann)
American Economic Journal: Economic Policy. Forthcoming.
Abstract
Public programs that provide benefits through private markets contend with strategic firm behavior. We study this dynamic in Medicare Part D. The Affordable Care Act closed a coverage gap in Part D by mandating drug manufacturers cover 50% of branded drug costs in the gap. Beneficiaries became 5 percentage points less likely to forgo prescriptions upon reaching the gap. However, manufacturers' response led to 21% higher drug prices, partially offsetting the insurance expansion. The closure was intended to be a $100 transfer to beneficiaries financed by manufacturers, but instead resulted in a $55 transfer to beneficiaries financed by the government.
Promoting Parents' Social Capital to Increase Children's Attendance in Head Start: Evidence From an Experimental Intervention
(with Teresa Sommer, Terri Sabol, Lindsay Chase-Lansdale, Mario Small, Henry Wilde, and Sean Brown)
Journal of Research on Educational Effectiveness. October 2017.
Abstract
Improving children's attendance is a high priority for Head Start and other early childhood education programs serving low-income children. We conducted a randomized control trial in a major northern city to evaluate the impact of a low-cost intervention designed to promote parents' social capital as a potential influence on children's attendance in Head Start centers. The intervention assigned children to treatment group classrooms based on (a) neighborhood of residence (geography condition) or (b) the geography condition plus the opportunity for parents to form partnerships in support of their children's attendance, or to control group classrooms according to Head Start guidelines only. We did not find impacts on average attendance throughout the year. However, the intervention did lead to increased attendance during the winter when average center attendance was lowest. There were no impacts on fall or spring attendance. Follow-up exploratory analyses of focus groups with parents and staff suggested that parents' level of connection and trust, self-generated partnership strategies, and commitment to their children's education may be factors by which parents' social capital expands and children's attendance improves.