Jacob Gruber
Biographic Data
| ID | 100075 |
|---|---|
| NAME | Jacob Gruber |
| GIVEN NAMES | Jacob |
| FAMILY NAME | Gruber |
| SIGNATURE | GRUBER J |
| AFFILIATIONS | National Bureau of Economic Research |
| ORCID | 0000-0003-0379-710X |
| VERIFIED | Yes |
| TOTAL WORKS | 52 |
| TOTAL CITATIONS | 259 |
| AUTHOR COUNT | 52 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1963 |
| LATEST PUBLICATION YEAR | 2023 |
| H-INDEX | 8 |
Saving Lives by Tying Hands: The Unexpected Effects of Constraining Health Care Providers
We study how emergency department (ED) doctors respond to incentives to reduce wait times. We use bunching techniques to study an English policy that imposed strong incentives to treat patients within four hours. The policy reduced time spent in the ED by 21 minutes for affected patients yet caused doctors to increase treatment intensity and admit more patients. We find a striking 14% reduction in mortality. Analysis of patient severity and hospi…
The importance of algorithm skills for informed Internet use
Using the Internet means encountering algorithmic processes that influence what information a user sees or hears. Existing research has shown that people's algorithm skills vary considerably, that they develop individual theories to explain these processes, and that their online behavior can reflect these understandings. Yet, there is little research on how algorithm skills enable people to use algorithms to their own benefit and to avoid harms t…
Staffing Patterns in US Nursing Homes During Covid-19 Outbreaks
In this cohort study of nursing homes experiencing severe COVID-19 outbreaks, facilities experienced considerable staffing challenges during and after outbreaks. These results suggest the need for policy action to ensure facilities' abilities to maintain adequate staffing levels during and after infectious disease outbreaks
The value of face-to-face communication in the digital world: What people miss about in-person interactions when those are limited
Face-to-face communication is important for building and maintaining relationships. The COVID-19 pandemic led to severe limitations in people’s face-to-face interactions, resulting in most people relying more heavily on digital communication for social connection. Existing research has contributed to the understanding of how face-to-face communication is used alongside digital communication. However, we know little about what elements of face-to-…
The impact of mental health support for the chronically ill on hospital utilisation: Evidence from the UK
Staying connected while physically apart: Digital communication when face-to-face interactions are limited
Theoretical and empirical work on digital media use and social connectedness has often considered face-to-face communication to be an available option. But how do various digital media uses relate to social connectedness when face-to-face communication is not, or much less, possible? Drawing on survey data from 2925 US adults during the early months of the COVID-19 pandemic, we find that different digital communication methods display different r…
Do income contingent student loans reduce labor supply
Government-backed income contingent student loans are increasingly being used to fund higher education. Until the outstanding balance is cleared, an income contingent repayment plan acts as an incremental marginal tax on earnings above a threshold. If this additional “tax” on earnings reduces the labor supply and hence the earnings of borrowers, this could reduce both loan repayments and tax receipts, increasing the cost of funding higher educati…
Black box measures? How to study people’s algorithm skills
Considerable scholarship has established that algorithms are an increasingly important part of what information people encounter in everyday life. Much less work has focused on studying users’ experiences with, understandings of, and attitudes about how algorithms may influence what they see and do. The dearth of research on this topic globally with diverse populations may be in part due to the difficulty of studying a subject about which there i…
Changes in Digital Communication During the Covid-19 Global Pandemic: Implications for Digital Inequality and Future Research
Governments and public health institutions across the globe have set social distancing and stay-at-home guidelines to battle the COVID-19 pandemic. With reduced opportunities to spend time together in person come new challenges to remain socially connected. This essay addresses how the pandemic has changed people's use of digital communication methods, and how inequalities in the use of these methods may arise. We draw on data collected from 1,37…
From Zero to a National Data Set in 2 Weeks: Reflections on a Covid-19 Collaborative Survey Project
In March 2020, like much of the rest of the world, we went into lockdown. A week into our new reality, we decided to do a survey study about how people were experiencing the COVID-19 pandemic. In this piece, we describe what motivated us to do the study, how we went about it, and what others can learn from our experiences
The Affordable Care Act's Effects on Patients, Providers, and the Economy: What We've Learned So Far
As we approach the tenth anniversary of the passage of the Affordable Care Act, it is important to reflect on what has been learned about the impacts of this major reform. In this paper, we review the literature on the impacts of the ACA on patients, providers, and the economy. We find strong evidence that the ACA's provisions have increased insurance coverage. There is also a clearly positive effect on access to and consumption of health care, w…
Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act
It’s Good to Be First: Order Bias in Reading and Citing NBER Working Papers
When choices are made from ordered lists, individuals can exhibit biases toward selecting certain options as a result of the ordering. We examine this phenomenon in the context of consumer response to the ordering of economics papers in an e-mail announcement issued by the NBER. We show that despite the effectively random list placement, papers listed first each week are about 30% more likely to be viewed, downloaded, and subsequently cited. We s…
Delivering Public Health Insurance Through Private Plan Choice in the United States
The United States has seen a sea change in the way that publicly financed health insurance coverage is provided to low-income, elderly, and disabled enrollees. When programs such as Medicare and Medicaid were introduced in the 1960s, the government directly reimbursed medical providers for the care that they provided, through a classic "single payer system." Since the mid-1980s, however, there has been an evolution towards a model where the gover…
Does Church Attendance Cause People to Vote? Using Blue Laws’ Repeal to Estimate the Effect of Religiosity on Voter Turnout
Regular church attendance is strongly associated with a higher probability of voting. It is an open question as to whether this association, which has been confirmed in numerous surveys, is causal. The repeal of the laws restricting Sunday retail activity (‘blue laws’) is used to measure the effects of church-going on political participation. Blue laws’ repeal caused a 5 percent decrease in church attendance. Its effect on political participation…
Measuring Returns to Hospital Care: Evidence from Ambulance Referral Patterns
Medicare spending exceeds 4% of GDP in the US each year, and there are concerns that moral hazard problems have led to overspending. This paper considers whether hospitals that treat patients more aggressively and receive higher payments from Medicare improve health outcomes for their patients. An innovation is a new lens to compare hospital performance for emergency patients: plausibly exogenous variation in ambulance-company assignment among pa…
An evaluation of the FDA's analysis of the costs and benefits of the graphic warning label regulation
The Family Smoking Prevention and Tobacco Control Act of 2009 gave the Food and Drug Administration (FDA) regulatory authority over cigarettes and smokeless tobacco products and authorised it to assert jurisdiction over other tobacco products. As with other Federal agencies, FDA is required to assess the costs and benefits of its significant regulatory actions. To date, FDA has issued economic impact analyses of one proposed and one final rule re…
The Oregon Experiment — Effects of Medicaid on Clinical Outcomes
BACKGROUND: Despite the imminent expansion of Medicaid coverage for low-income adults, the effects of expanding coverage are unclear. The 2008 Medicaid expansion in Oregon based on lottery drawings from a waiting list provided an opportunity to evaluate these effects. METHODS: Approximately 2 years after the lottery, we obtained data from 6387 adults who were randomly selected to be able to apply for Medicaid coverage and 5842 adults who were not…
The Oregon Health Insurance Experiment: Evidence from the First Year
In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage …
The facts from Massachusetts speak clearly: Response to Douglas Holtz‐Eakin
Massachusetts points the way to successful health care reform
Abortion and Selection
Abortion legalization in the early 1970s led to dramatic changes in fertility. Some research has suggested that it altered cohort outcomes, but this literature has been limited and controversial. In this paper, we provide a framework for understanding selection mechanisms and use that framework to both address inconsistent past methodological approaches and provide evidence on the long-run impact on cohort characteristics. Our results indicate th…
The Evolution of Medical Spending Risk
How has the economic risk of health spending changed over time for U.S. households? We describe trends in aggregate health spending in the United States and how private insurance markets and public insurance programs have changed over time. We then present evidence from Consumer Expenditure Survey microdata on how the distribution of household spending on health—that is, out-of-pocket payments for medical care plus the household's share of health…
The Church versus the Mall: What Happens When Religion Faces Increased Secular Competition?
Recently economists have begun to consider the causes and consequences of religious participation. An unanswered question in this literature is the effect upon individuals of changes in the opportunity cost of religious participation. In this paper we identify a policy-driven change in the opportunity cost of religious participation based on state laws that prohibit retail activity on Sunday, known as “blue laws.” Many states have repealed these …
Nursing Home Quality as a Common Good
A long-standing assumption among economists is that nursing home quality is common across Medicaid and private-pay patients within a shared facility. However, there has been only limited empirical work addressing this issue. Using a unique individual level panel of residents of nursing homes from seven states, we exploit both within-facility and within-person variation in payer source and quality to examine this issue. We also test the robustness…
Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women
The authors provide direct evidence on the effect of health insurance on health outcomes by examining the dramatic increases in the eligibility of pregnant women for the Medicaid program between 1979 and 1992. They find that the 30-percentage-point rise in Medicaid eligibility significantly lowered the incidence of low birth weight and infant mortality. Targeted changes in Medicaid eligibility that were restricted to specific low-income groups ha…
Universal Child Care, Maternal Labor Supply, and Family Well‐Being
We analyze the introduction of highly subsidized, universally accessible child care in Quebec, addressing the impact on child care utilization, maternal labor supply, and family well-being. We find strong evidence of a shift into new child care use, although some crowding out of existing arrangements is evident. Maternal labor supply increases significantly. Finally, the evidence suggests that children are worse off by measures ranging from aggre…
Public Health Insurance and Private Savings
Recent theoretical work suggests that means and asset-tested social insurance programs can explain the low savings of lower income households in the U.S. We assess the validity of this hypothesis by investigating the effect of Medicaid, the health insurance program for low income women and children, on savings behavior. We do so using data on asset holdings from the Survey of Income and Program Participation, and on consumption from the Consumer …
Staying connected while physically apart: Digital communication when face-to-face interactions are limited
Theoretical and empirical work on digital media use and social connectedness has often considered face-to-face communication to be an available option. But how do various digital media uses relate to social connectedness when face-to-face communication is not, or much less, possible? Drawing on survey data from 2925 US adults during the early months of the COVID-19 pandemic, we find that different digital communication methods display different r…
Does Church Attendance Cause People to Vote? Using Blue Laws’ Repeal to Estimate the Effect of Religiosity on Voter Turnout
Regular church attendance is strongly associated with a higher probability of voting. It is an open question as to whether this association, which has been confirmed in numerous surveys, is causal. The repeal of the laws restricting Sunday retail activity (‘blue laws’) is used to measure the effects of church-going on political participation. Blue laws’ repeal caused a 5 percent decrease in church attendance. Its effect on political participation…
Changes in Digital Communication During the Covid-19 Global Pandemic: Implications for Digital Inequality and Future Research
Governments and public health institutions across the globe have set social distancing and stay-at-home guidelines to battle the COVID-19 pandemic. With reduced opportunities to spend time together in person come new challenges to remain socially connected. This essay addresses how the pandemic has changed people's use of digital communication methods, and how inequalities in the use of these methods may arise. We draw on data collected from 1,37…
Health Insurance and Job Mobility: The Effects of Public Policy on Job-Lock
The authors study a policy of limited insurance portability that has been adopted by a number of states and the federal government over the past 20 years. They find that these "continuation of coverage" mandates, which grant individuals the right to continue purchasing health insurance through their former employers for a specified period after leaving their jobs, are associated with a significant increase in the job mobility of prime age male wo…
The Wealth of the Unemployed
Many studies have investigated the adequacy of unemployment insurance (UI) benefits as a form of income replacement, but few have looked at other resources with which the unemployed can finance their unemployment spells. This paper focuses on one form of resources, own wealth holdings. The author finds that the median worker's financial assets can cover roughly two-thirds of the income loss from an unemployment spell. Wealth holdings vary tremend…
Disability Insurance Benefits and Labor Supply
A critical input for assessing the optimal size of disability insurance programs is the elasticity of labor force participation with respect to the generosity of benefits. Unfortunately, this parameter has been difficult to estimate in the context of the U.S. disability insurance program since all workers face an identical benefits schedule. I surmount this problem by studying the experience of Canada, which operates two distinct disability insur…
The value of face-to-face communication in the digital world: What people miss about in-person interactions when those are limited
Face-to-face communication is important for building and maintaining relationships. The COVID-19 pandemic led to severe limitations in people’s face-to-face interactions, resulting in most people relying more heavily on digital communication for social connection. Existing research has contributed to the understanding of how face-to-face communication is used alongside digital communication. However, we know little about what elements of face-to-…
Measuring Returns to Hospital Care: Evidence from Ambulance Referral Patterns
Medicare spending exceeds 4% of GDP in the US each year, and there are concerns that moral hazard problems have led to overspending. This paper considers whether hospitals that treat patients more aggressively and receive higher payments from Medicare improve health outcomes for their patients. An innovation is a new lens to compare hospital performance for emergency patients: plausibly exogenous variation in ambulance-company assignment among pa…
Massachusetts points the way to successful health care reform
Tobacco At the Crossroads: The Past and Future of Smoking Regulation in the United States
The past five years have seen a dramatic turn of events against the tobacco industry, raising the question of the appropriate future path for smoking policy in the U.S. This paper discusses the theory and evidence on regulation of smoking. I begin by reviewing the background on this industry. I then turn to a discussion of the motivations for regulating smoking, both external and internal to the smoker. I review the evidence on the effects of exi…
The Affordable Care Act's Effects on Patients, Providers, and the Economy: What We've Learned So Far
As we approach the tenth anniversary of the passage of the Affordable Care Act, it is important to reflect on what has been learned about the impacts of this major reform. In this paper, we review the literature on the impacts of the ACA on patients, providers, and the economy. We find strong evidence that the ACA's provisions have increased insurance coverage. There is also a clearly positive effect on access to and consumption of health care, w…
The Economic Impacts of the Tobacco Settlement
Recent litigation against the major tobacco companies culminated in a master settlement agreement (MSA) under which the participating companies agreed to compensate most states for Medicaid expenses. Here the terms of the settlement are outlined and its economic implications analyzed using data from Massachusetts. The financial compensation to Massachusetts (and other states) under the MSA is substantial. However, this compensation is dwarfed by …
Man's Discovery of His Past: Literary Landmarks in Archaeology
The importance of algorithm skills for informed Internet use
Using the Internet means encountering algorithmic processes that influence what information a user sees or hears. Existing research has shown that people's algorithm skills vary considerably, that they develop individual theories to explain these processes, and that their online behavior can reflect these understandings. Yet, there is little research on how algorithm skills enable people to use algorithms to their own benefit and to avoid harms t…
From Zero to a National Data Set in 2 Weeks: Reflections on a Covid-19 Collaborative Survey Project
In March 2020, like much of the rest of the world, we went into lockdown. A week into our new reality, we decided to do a survey study about how people were experiencing the COVID-19 pandemic. In this piece, we describe what motivated us to do the study, how we went about it, and what others can learn from our experiences
General and Ethnology: Parker on the Iroquois: Iroquois Uses of Maize and Other Food Plants; The Code of Handsome Lake, the Seneca Prophet; The Constitution of the Five Nations. William N. Fenton, ed
Man's Discovery of His Past: Literary Landmarks in Archaeology
Other: A Guide to Manuscripts Relating to the American Indian in the Library of the American Philosophical Society. John F. Freeman, compiler, and Murphy D. Smith
General and Ethnology: Parker on the Iroquois: Iroquois Uses of Maize and Other Food Plants; The Code of Handsome Lake, the Seneca Prophet; The Constitution of the Five Nations. William N. Fenton, ed
Rationing America's Medical Care: The Oregon Plan and beyond
Health Insurance and Job Mobility: The Effects of Public Policy on Job-Lock
The authors study a policy of limited insurance portability that has been adopted by a number of states and the federal government over the past 20 years. They find that these "continuation of coverage" mandates, which grant individuals the right to continue purchasing health insurance through their former employers for a specified period after leaving their jobs, are associated with a significant increase in the job mobility of prime age male wo…
The Labor-Marker Effects of Introducing National Health Insurance: Evidence From Canada
Although national health insurance (NHI) plans in the United States are often opposed on the basis of their potential disemployment effects, there is no existing evidence on the effects of NHI on employment. We provide such evidence by examining the employment consequences of NHI in Canada, using the fact that NHI was introduced on a staggered basis across Canadian provinces. We examine monthly data on employment, wages, and hours across 8 indust…
The Labor-Market Effects of Introducing National Health Insurance: Evidence from Canada
Jonathan Gruber, Maria Hanratty, The Labor-Market Effects of Introducing National Health Insurance: Evidence from Canada, Journal of Business & Economic Statistics, Vol. 13, No. 2, JBES Symposium on Program and Policy Evaluation (Apr., 1995), pp. 163-173
Does Public Insurance Crowd out Private Insurance?
The cost of expanding public sector health programs depends critically on the extent to which public eligibility will cover just the uninsured, or will crowd out existing private insurance coverage. We estimate the extent of crowd-out arising from the expansions of Medicaid to pregnant women and children over the 1987–1992 period. We estimate that approximately 50 percent of the increase in Medicaid coverage was associated with a reduction in pri…
Health Insurance Eligibility, Utilization of Medical Care, and Child Health
We study the effect of public insurance for children on their utilization of medical care and health outcomes by exploiting recent expansions of the Medicaid program to low-income children. These expansions doubled the fraction of children eligible for Medicaid between 1984 and 1992. Take-up of these expansions was much less than full, however, even among otherwise uninsured children. Despite this take-up problem, eligibility for Medicaid signifi…
Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women
The authors provide direct evidence on the effect of health insurance on health outcomes by examining the dramatic increases in the eligibility of pregnant women for the Medicaid program between 1979 and 1992. They find that the 30-percentage-point rise in Medicaid eligibility significantly lowered the incidence of low birth weight and infant mortality. Targeted changes in Medicaid eligibility that were restricted to specific low-income groups ha…
Policy Watch: Medicaid and Uninsured Women and Children
This paper focuses on the role of Medicaid, the public health insurance program for low income populations, as a means of reducing uninsurance among uninsured women and children. The author discusses the structure of the Medicaid program and recent findings of its effects on insurance status, medical utilization, and health. He concludes that public insurance can be a cost-effective tool for reducing uninsurance and improving health, but only if …
Public Health Insurance and Private Savings
Recent theoretical work suggests that means and asset-tested social insurance programs can explain the low savings of lower income households in the U.S. We assess the validity of this hypothesis by investigating the effect of Medicaid, the health insurance program for low income women and children, on savings behavior. We do so using data on asset holdings from the Survey of Income and Program Participation, and on consumption from the Consumer …
Does Unemployment Insurance Crowd out Spousal Labor Supply
Previous research on unemployment insurance (UI) has emphasized the program's effect on individual search behavior. This state‐contingent income may also reduce the labor supply of family members during the unemployment spell. We investigate this question within the context of wives' labor supply responses to their husbands' unemployment spells. We find strong “crowdout” of this form of family self‐insurance; our estimates imply that for each dol…
The Economic Impacts of the Tobacco Settlement
Recent litigation against the major tobacco companies culminated in a master settlement agreement (MSA) under which the participating companies agreed to compensate most states for Medicaid expenses. Here the terms of the settlement are outlined and its economic implications analyzed using data from Massachusetts. The financial compensation to Massachusetts (and other states) under the MSA is substantial. However, this compensation is dwarfed by …
Disability Insurance Benefits and Labor Supply
A critical input for assessing the optimal size of disability insurance programs is the elasticity of labor force participation with respect to the generosity of benefits. Unfortunately, this parameter has been difficult to estimate in the context of the U.S. disability insurance program since all workers face an identical benefits schedule. I surmount this problem by studying the experience of Canada, which operates two distinct disability insur…
Is Addiction "Rational"? Theory and Evidence
This paper makes two contributions to the modeling of addiction. First, we provide new and convincing evidence that smokers are forward-looking in their smoking decisions, using state excise tax increases that have been legislatively enacted but are not yet effective, and monthly data on consumption. Second, we recognize the strong evidence that preferences with respect to smoking are time inconsistent, with individuals both not recognizing the t…
Transitional Subsidies for Health Insurance Coverage
Losing or leaving a job often means losing health insurance. Of all those who have lost private insurance and become uninsured, one-third have either left or lost a job in the recent past. Continuation of coverage subsidies under the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 mitigate only slightly this problem due to the high costs of the group coverage that must be purchased. This paper discusses a proposal to build on the s…
Tobacco At the Crossroads: The Past and Future of Smoking Regulation in the United States
The past five years have seen a dramatic turn of events against the tobacco industry, raising the question of the appropriate future path for smoking policy in the U.S. This paper discusses the theory and evidence on regulation of smoking. I begin by reviewing the background on this industry. I then turn to a discussion of the motivations for regulating smoking, both external and internal to the smoker. I review the evidence on the effects of exi…
The Wealth of the Unemployed
Many studies have investigated the adequacy of unemployment insurance (UI) benefits as a form of income replacement, but few have looked at other resources with which the unemployed can finance their unemployment spells. This paper focuses on one form of resources, own wealth holdings. The author finds that the median worker's financial assets can cover roughly two-thirds of the income loss from an unemployment spell. Wealth holdings vary tremend…
Insuring Consumption Against Illness
One of the most sizable and least predictable shocks to economic opportunities in developing countries is major illness. We investigate the extent to which families are able to insure consumption against major illness using a unique panel data set from Indonesia that combines excellent measures of health status with consumption information. We find that there are significant economic costs associated with major illness, and that there is very imp…
Is Making Divorce Easier Bad for Children? The Long‐Run Implications of Unilateral Divorce
I assess the long‐run implications for children of growing up in a unilateral divorce environment, which increases the ease of divorce by not requiring the explicit consent of both partners. Using 40 years of census data to exploit the variation across states and over time in changes in divorce regulation, I confirm that unilateral divorce regulations do significantly increase the incidence of divorce. Adults who were exposed to unilateral divorc…
Faith-Based Charity and Crowd Out during the Great Depression
Interest in religious organizations as providers of social services has increased dramatically in recent years. Churches in the U.S. were a crucial provider of social services through the early part of the twentieth century, but their role shrank dramatically with the expansion in government spending under the New Deal. In this paper, we investigate the extent to which the New Deal crowded out church charitable spending in the 1930s. We do so usi…
The Church vs the Mall: What Happens When Religion Faces Increased Secular Competition?
Recently economists have begun to consider the causes and consequences of religious participation. An unanswered question in this literature is the effect upon individuals of changes in the opportunity cost of religious participation. In this paper we identify a policy-driven change in the opportunity cost of religious participation based on state laws that prohibit retail activity on Sunday, known as "blue laws." Many states have repealed these …
Money and Mandates: Relative Effects of Key Policy Levers in Expanding Health Insurance Coverage to All Americans
This study examines the relative effects of three policy levers on health coverage and costs in plans aimed at covering all Americans. Specifically, using microsimulation analysis and hypothetical proposals, it assesses how the generosity of financial assistance, an employer mandate, and an individual mandate affect the level of uninsurance, distribution of coverage, and federal costs, holding delivery system and benefits constant. The results su…
Future Social Security Entitlements and the Retirement Decision
A critical question for Social Security policy is how program incentives affect retirement behavior. We use the Health and Retirement Survey (HRS) to examine the impact of Social Security incentives on male retirement. We implement forward-looking models whereby individuals consider the incentives to work in all future years. We find that forward-looking incentive measures for Social Security are significant determinants of retirement. We also fi…
Economics (35 works) · Healthcare Policy and Management (25 works) · Medicine (22 works) · Business (21 works) · Demographic economics (20 works) · Global Health Care Issues (20 works) · Health care (19 works) · Political science (18 works) · Economic growth (17 works) · Computer Science (15 works)