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Children’s Mental Disorders and Their Mothers’ Earnings: Implications for the Affordable Care Act of 2010

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Abstract

Children with emotional and behavioral problems (EBP) may have a negative effect on their mothers’ earnings because they require additional time for treatment. On the other hand, children with EBP require additional financial resources, which may increase their mothers’ earnings through an increase in work activities. This study examined the impact of children’s EBP on parental earnings, while accounting for omitted variable bias. This study found significant reductions of single mothers’ wage rate/annual earnings if their children have EBP. Conversely, children’s EBP increased their married mothers’ hourly wage. These results have important implications in terms of public policy such as the Affordable Care Act (ACA) of 2010 in terms of expanding health insurance coverage to children with EBP to have access to appropriate treatment.

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Notes

  1. Medicaid is a health insurance program in the US that provides coverage to low income and disabled individuals and families (Bitler and Zavodny 2014; Buchmueller et al. 2015). Recently, Medicaid is expanding because of the enactment of the Patient Protection and Affordable Care Act of 2010, designed to improve health outcomes by increasing health insurance access (Bitler and Zavodny 2014; Buchmueller et al. 2015).

References

  • Achenbach, T. M., & Edelbrock, C. S. (1981). Behavioral problems and competencies reported by parents of normal and disturbed children aged four through sixteen. Monographs of the Society for Research in Child Development, 46(1), 1–82.

    Article  Google Scholar 

  • Aizer, A. (2003). Low take-up in medicaid: Does outreach matter and for whom? American Economic Review Papers and Proceedings, 93(2), 238–241. doi:10.1257/000282803321947119.

    Article  Google Scholar 

  • Aizer, A. (2007). Public health insurance, program take-up, and child health. The Review of Economics and Statistics, 89(3), 400–415. doi:10.1162/rest.89.3.400.

    Article  Google Scholar 

  • Arrow, K. J. (1963). Uncertainty and the welfare economics of medical care. The American Economic Review, 53(5), 941–973.

    Google Scholar 

  • Baicker, K., & Finkelstein, A. (2011). The effects of Medicaid coverage-learning from the Oregon Experiment. The New England Journal of Medicine, 365, 683–685. doi:10.1056/NEJMp1108222.

    Article  Google Scholar 

  • Baicker, K., Taubman, S. L., Allen, H. L., Bernstein, M., Gruber, J. H., Newhouse, J. P., et al. (2013). The Oregon experiment-effects of Medicaid on clinical outcomes. The New England Journal of Medicine, 368(18), 1713–1722. doi:10.1056/NEJMsa1212321.

    Article  Google Scholar 

  • Baker, L. C., & Afendulis, C. (2005). Medicaid managed care and health care for children. Health Services Research, 40(5), 1466–1488.

    Article  Google Scholar 

  • Becker, G. S. (1964). Human capital: A theoretical and empirical analysis, with special reference to education. New York: National Bureau of Economic Research.

    Google Scholar 

  • Becker, G. (1981). A treatise on the family. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Bednarek, H. L., & Hudson, J. L. (2003). Child disability and mothers’ labor supply. Presented at the AEA Meeting, St. Louis University, St. Louis.

  • Beronio, K., Glied, S., & Frank, R. (2014). How the Affordable Care Act and Mental Health Parity and Addiction Equity Act greatly expand coverage of behavioral health care. The Journal of Behavioral Health Services & Research, 41(4), 410–428. doi:10.1007/s11414-014-9412-0.

    Article  Google Scholar 

  • Bitler, M. P., & Zavodny, M. (2014). Medicaid: A review of the literature. The National Bureau of Economic Research, No. w20169. doi: 10.3386/w20169.

  • Bound, J. (1991). Self-reported versus objective measures of health in retirement models. Journal of Human Resources, 26(1), 106–138. doi:10.2307/145718.

    Article  Google Scholar 

  • Buchmueller, T. C., Cooper, P. F., Jacobson, M., & Zuvekas, S. H. (2007). Parity for whom? Exemptions and the extent of state mental health parity legislation. Health Affairs (Millwood), 26(4), w483–w487. doi:10.1377/hlthaff.26.4.w483.

    Article  Google Scholar 

  • Buchmueller, T., Ham, J. C., & Shore-Sheppard, L. D. (2015). The Medicaid Program. The National Bureau of Economic Research, No. w21425. doi:10.3386/w21425.

  • Case, A., Lubotsky, D., & Paxson, C. (2002). Economic status and health in childhood: The origins of the gradient. The American Economic Review, 92(5), 1308–1334. doi:10.3386/w8344.

    Article  Google Scholar 

  • Coley, R. L., Ribar, D., & Votruba-Drzal, E. (2011). Do children’s behavior problems limit poor women’s labor market success? Journal of Marriage and Family, 73(1), 33–45. doi:10.1111/j.1741-3737.2010.00787.x.

    Article  Google Scholar 

  • Corman, H., Noonan, K., & Reichman, N. E. (2005). Mothers’ labor supply in fragile families: The role of child health. Eastern Economic Journal, 31(4), 601–616.

    Google Scholar 

  • Currie, J., Decker, S., & Lin, W. (2008). Has public health insurance for older children reduced disparities in access to care and health outcomes? Journal of Health Economics, 27(6), 1567–1581. doi:10.1016/j.jhealeco.2008.07.002.

    Article  Google Scholar 

  • Currie, J., & Gruber, J. (1996). Health insurance eligibility, utilization of medical care, and child health. The Quarterly Journal of Economics, 111(2), 431–466. doi:10.3386/w5052.

    Article  Google Scholar 

  • Cutler, D. M., & Zeckhauser, R. J. (2000). The anatomy of health insurance. Handbook of Health Economics, 1(A), 563–643. doi:10.1016/S1574-0064(00)80170-5.

    Article  Google Scholar 

  • Dafny, L., & Gruber, J. (2005). Public insurance and child hospitalizations: Access and efficiency effects. Journal of Public Economics, 89(1), 109–129. doi:10.1016/j.jpubeco.2003.05.004.

    Article  Google Scholar 

  • Davidson, R., & MacKinnon, J. G. (1993). Estimation and inference in econometrics. OUP Catalogue.

  • Finkelstein, A., Taubman, S., Wright, B., Bernstein, M., Gruber, J., Newhouse, J. P., et al. (2012). The Oregon Health Insurance Experiment: Evidence from the first year. Quarterly Journal of Economics, 127(3), 1057–1106. doi:10.3386/w17190.

    Article  Google Scholar 

  • Frank, R. G., & McGuire, T. G. (2000). Economics and mental health. Handbook of Health Economics, 1(B), 893–954. doi:10.1016/S1574-0064(00)80029-3.

    Article  Google Scholar 

  • Garrett, B., Davidoff, A. J., & Yemane, A. (2003). Effects of Medicaid managed care programs on health services access and use. Health Services Research, 38(2), 575–594. doi:10.1111/1475-6773.00134.

    Article  Google Scholar 

  • Goodman-Bacon, A. (2013). Public insurance and mortality: Evidence from Medicaid implementation. Ann Arbor, MI: University of Michigan.

    Google Scholar 

  • Gould, E. (2004). Decomposing the effects of children’s health on mother’s labor supply: Is it time or money? Health Economics, 13(6), 525–541. doi:10.1002/hec.891.

    Article  Google Scholar 

  • Grossman, M. (1972). On the concept of health capital and the demand for health. Journal of Political Economy, 80(2), 223–255. doi:10.1086/259880.

    Article  Google Scholar 

  • Haggins, A., Patrick, S., Demonner, S., & Davis, M. M. (2013). When coverage expands: Children’s health insurance program as a natural experiment in use of health care services. Academic Emergency Medicine, 20(10), 1026–1032. doi:10.1111/acem.12236.

    Article  Google Scholar 

  • Heckman, J. J. (1979). Sample selection bias as a specification error. Econometrica, 47, 153–161. doi:10.2307/1912352.

    Article  Google Scholar 

  • Jessor, R. (1991). Risk behavior in adolescence: A psychosocial framework for understanding and action. Journal of Adolescent Health, 12(8), 597–605. doi:10.1016/1054-139X(91)90007-K.

    Article  Google Scholar 

  • Kaestner, R., Joyce, T., & Racine, A. (2001). Medicaid eligibility and the incidence of ambulatory care sensitive hospitalizations for children. Social Science and Medicine, 52(2), 305–313. doi:10.1016/S0277-9536(00)00133-7.

    Article  Google Scholar 

  • Kvist, A. P., Nielsen, H. S., & Simonsen, M. (2013). The importance of children’s ADHD for parents’ relationship stability and labor supply. Social Science and Medicine, 88, 30–38. doi:10.1016/j.socscimed.2013.04.001.

    Article  Google Scholar 

  • Lundberg, S., & Rose, E. (2002). The effects of sons and daughters on men’s labor supply and wages. Review of Economics and Statistics, 84(2), 251–268. doi:10.1162/003465302317411514.

    Article  Google Scholar 

  • McLanahan, S., & Sandefur, G. (1995). Growing up with a single parent. What hurts, what helps. New England Journal of Medicine, 332, 966–968. doi:10.1056/NEJM19950463321422.

    Article  Google Scholar 

  • Moffitt, R., & Wolfe, B. L. (1992). The effect of the Medicaid Program on welfare participation and labor supply. The Review of Economic and Statistics, MIT Press, 74(4), 615–626. doi:10.1056/NEJM19950463321422.

    Article  Google Scholar 

  • Morris, L. A. (2012). Testing respite effect of work on stress among mothers of children with special needs. Journal of Family and Economic Issues, 33(1), 24–40. doi:10.1007/s10834-011-9267-y.

    Article  Google Scholar 

  • Nes, R. B., Hauge, L. J., Kornstad, T., Kristensen, P., Landolt, M. A., Eskedal, L. T., & Vollrath, M. E. (2014). The impact of child behaviour problems on maternal employment: A longitudinal cohort study. Journal of Family and Economic Issues, 35(3), 351–361. doi:10.1007/s10834-013-9378-8.

    Article  Google Scholar 

  • Pauly, M. V. (1968). The economics of moral hazard: Comment. American Economic Review, 58(3), 531–537. doi:10.1017/CBO9780511528248.009.

    Google Scholar 

  • Pedersen, D. E., & Kilzer, G. (2014). Work-to-family conflict and the maternal gatekeeping of dual-earner mothers with young children. Journal of Family and Economic Issues, 35(2), 251–262. doi:10.1007/s10834-013-9370-3.

    Article  Google Scholar 

  • Peterson, J. L., & Zill, N. (1986). Marital disruption, parent-child relationships, and behavior problems in children. Journal of Marriage and Family, 48(2), 295–307. doi:10.2307/352397.

    Article  Google Scholar 

  • Pollitz, K., Cox, C., Lucia, K., & Keith, K. (2014). Medical debt among people with health insurance. Kaiser Family Foundation.

  • Porterfield, S. L. (2002). Work choices of mothers in families with children with disabilities. Journal of Marriage and Family, 64(4), 972–981. doi:10.1111/j.1741-3737.2002.00972.x.

    Article  Google Scholar 

  • Powers, E. T. (2001). New estimates of the impact of child disability on maternal employment. American Economic Review, 91(2), 135–139. doi:10.1257/aer.91.2.135.

    Article  Google Scholar 

  • Powers, E. T. (2003). Children’s health and maternal work activity estimates under alternative disability definitions. Journal of Human Resources, 38(3), 522–556. doi:10.2307/1558767.

    Article  Google Scholar 

  • Puhani, P. (2000). The Heckman correction for sample selection and its critique. Journal of Economic Surveys, 14(1), 53–68. doi:10.1111/1467-6419.00104.

    Article  Google Scholar 

  • Richard, P., Gaskin, D. J., Alexandre, P. K., Burke, L. S., & Younis, M. (2014). Children’s emotional and behavioral problems and their mothers’ labor supply. INQUIRY, 51, 1–13. doi:10.1177/0046958014557946.

    Google Scholar 

  • Rowan, K., McAlpine, D. D., & Blewett, L. A. (2013). Access and cost barriers to mental health care, by insurance status, 1999–2010. Health Affairs, 32(10), 1723–1730. doi:10.1377/hlthaff.2013.0133.

    Article  Google Scholar 

  • Sartori, A. E. (2003). An estimator for some binary-outcome selection models without exclusion restrictions. Political Analysis, 11(2), 111–138. doi:10.1093/pan/mpg001.

    Article  Google Scholar 

  • Sigelman, L., & Zeng, L. (1999). Analyzing censored and sample-selected data with Tobit and Heckit models. Political Analysis, 8(2), 167–182. doi:10.1093/oxfordjournals.pan.a029811.

    Article  Google Scholar 

  • Staiger, D. O., & Stock, J. H. (1997). Instrumental variables regression with weak instruments. Econometrica, 65(3), 557–586. doi:10.2307/2171753.

    Article  Google Scholar 

  • Tang, S. F. S. (2004). Emergency room use among low-income children: Does health insurance coverage make a difference. Pediatric Research, 55(4), 229A.

    Google Scholar 

  • Taubman, S. L., Allen, H. L., Wright, B. J., Baicker, K., & Finkelstein, A. N. (2014). Medicaid increases emergency-department use: Evidence from Oregon’s Health Insurance Experiment. Science, 343(6168), 263–268. doi:10.1126/science.1246183.

    Article  Google Scholar 

  • Tomohara, A., & Lee, H. J. (2007). Did State Children’s Health Insurance Program affect married women’s labor supply? Journal of Family and Economic Issues, 28(4), 668–683.

    Article  Google Scholar 

  • Varon, S. R., & Riley, A. W. (1999). Relationship between maternal church attendance and adolescent mental health and social functioning. Psychiatric Services, 50(6), 799–805.

    Article  Google Scholar 

  • Wasi, N., van den Berg, B., & Buchmueller, T. C. (2012). Heterogeneous effects of child disability on maternal labor supply: Evidence from the 2000 US Census. Labour Economics, 19(1), 139–154.

    Google Scholar 

  • Watts, S. H., David Bryan, E., & Tarwater, P. M. (2015). Changes in insurance status and emergency department visits after the 2008 economic downturn. Academic Emergency Medicine, 22(1), 73–80. doi:10.1111/acem.12553.

    Article  Google Scholar 

  • Wooldridge, J. M. (2002). Econometric analysis of cross section and panel data. Cambridge, MA: The MIT Press.

    Google Scholar 

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Acknowledgments

This study was funded by the National Institute of Mental Health (NIMH) Economics Training Program at Johns Hopkins University.

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  1. Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA

    Patrick Richard

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Richard, P. Children’s Mental Disorders and Their Mothers’ Earnings: Implications for the Affordable Care Act of 2010. J Fam Econ Iss 37, 156–171 (2016). https://doi.org/10.1007/s10834-016-9486-3

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