Targeting with In-Kind Transfers: Evidence from Medicaid Home Care

• 成果类型: Article
• 署名作者: Lieber, Ethan M. J.; Lockwood, Lee M.
• 署名单位: University of Notre Dame; University of Virginia; National Bureau of Economic Research
• 刊物名称: AMERICAN ECONOMIC REVIEW
• ISSN/ISSBN: 0002-8282
• DOI: 10.1257/aer.20180325
• 发表日期: 2019
• 页码: 1461-1485
• 关键词: long-term-care; self-selection; field experiment; insurance; cash; efficient; tradeoff; HEALTH; IMPACT

摘要

Making a transfer in kind reduces its value to recipients but can improve targeting. We develop an approach to quantiffing this trade-off and apply it to home care. Using randomized experiments by Medicaid, we find that in-kind provision significantly reduces the value of the transfer to recipients while targeting a small fraction of the eligible population that is sicker and has fewer informal care-givers than the average eligible. Under a wide range of assumptions within a standard model, the targeting benefit exceeds the distortion cost. This highlights an important cost of recent reforms toward more flexible benefits. (JEL D82, H51, H75, I18, I38)