Who benefits from public financing of home-based long term care? Evidence from Medicaid

• 成果类型: Article
• 署名作者: Shen, Karen
• 署名单位: Johns Hopkins University; Johns Hopkins Bloomberg School of Public Health
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2024.105151
• 发表日期: 2024
• 关键词: Medicaid; Female labor force participation; long-term care; Home-and community-based services; Home care

摘要

Due to population aging, the number of people needing long-term care is growing, and an increasing number of people are receiving this care at home, rather than in nursing homes. This trend has been driven in part by Medicaid, which has significantly increased public financing of formal home care over the past few decades. Using the 2000-2016 Health and Retirement Study and a difference-in-difference and triple-difference design, I investigate the effects of a Medicaid policy adopted in over half of states that increased formal home care utilization among low-income older adults by more than 50%. I show that the policy mainly replaces informal care, particularly from spouses and daughters. For daughters, there is an accompanying increase in labor supply: for approximately every three daughters whose parent receives formal home care due to the policy, one additional daughter works full -time.