THREE ESSAYS IN HEALTH ECONOMICS

Abstract

This dissertation consists of three essays in health economics. The first chapter estimates changes in sexually transmitted disease rates for young adults in the United States following the Affordable Care Act’s dependent coverage mandate; a provision that allows dependents to remain covered under their parents’ health insurance plans until the age of 26. This study is the first to analyze changes in reported chlamydia and gonorrhea rates resulting from the dependent coverage mandate. Utilizing a difference-in-differences framework coupled with administrative data from the Centers for Disease Control and Prevention, I find that reported chlamydia rates increased for males and females ages 20-24 relative to comparison groups of males and females ages 15-19 and 25-29 following the mandate. I also find evidence of an increase in gonorrhea rates for females in this age group. I find no evidence that the mandate induced ex ante moral hazard. The second chapter estimates the relationship between state-level factors and the passage of electronic cigarette regulation. E-cigarettes are controversial products. They may help addicted smokers to consume nicotine in a less harmful manner or to quit tobacco cigarettes entirely, but these products may also entice youth into smoking. This controversy complicates e-cigarette regulation as any regulation may lead to health improvements for some populations and health declines for other populations. Using data from 2007 to 2016, we examine factors that are plausibly linked with U.S. state e-cigarette regulations. We find that less conservative states are more likely to regulate e-cigarettes and that states with stronger tobacco lobbies are less likely to regulate e-cigarettes. This information can help policymakers as they determine how best to promote public health through regulation. The third chapter estimates the effect of changes in the number of family planning clinics on county-level fertility rates. Results suggest that increasing the number of clinics in a county decreases the fertility rate by .3 percent. These results are likely biased downward due to the inclusion of multiple types of clinics (i.e., fertility and contraceptive).