Health Insurance Dynamics

Insurance coverage in the United States can be complicated and might involve transitions between private and public coverage—and in some cases loss of insurance due to job loss. These changes can impact access to health care and increase the likelihood of financial challenges. Because most Americans access health insurance through an employer-sponsored plan, coverage is tied to labor market fluctuations. But what happens when insurance coverage is interrupted because of employment separation?

To explore the dynamics between health insurance and employment in the United States, the Chicago Fed hosted a virtual event from 11:00 am -12:00 pm CT on May 9, 2024. During the event, Chicago Fed economists presented research on the impact of insurance transitions on policyholders who become unemployed and the effect of expanded Medicaid access following an involuntary loss of private employer health insurance. The research presentations were followed by a panel featuring experts in the fields of medicine and public health who discussed the policy implications of insurance transitions and Medicaid access for workers and their families.

Thursday, 05/09/24
11:00 AM
Opening Remarks
Speaker
Anna Paulson, Executive Vice President, Director of Research and Executive Committee Member, Federal Reserve Bank of Chicago
11:03 AM
How Health Insurance Improves Financial Health
Speaker
Bhash Mazumder, Senior Economist and Economic Advisor, Federal Reserve Bank of Chicago
11:16 AM
Medicaid-ing Uninsurance: Evidence from the Affordable Care Act
Speaker
Shanthi Ramnath, Senior Economist and Economic Advisor, Federal Reserve Bank of Chicago
11:30 AM
Panel Discussion & Audience Questions
Panelists
James Capretta, Milton Friedman Chair, American Enterprise Institute
Anthony LoSasso, Professor and Chair of the Department of Economics, DePaul University
Angela Harper Mahome, Psychiatrist, Montrose Behavioral Health Hospital
Robin Rudowitz, Vice President and Director, Medicaid and the Uninsured
11:58 AM
Closing Remarks
Speaker
Kristen Broady, Senior Economist and Economic Advisor and Director of the Economic Mobility Project, Federal Reserve Bank of Chicago
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Speaker

Kristen Broady

Senior Economist and Economic Advisor and Director of the Economic Mobility Project
Federal Reserve Bank of Chicago

Dr. Kristen Broady is a Senior Economist, Economic Advisor, and Director of the Economic Mobility Project at the Federal Reserve Bank of Chicago. Broady is a nonresident senior fellow at Brookings Metro. Before joining the Chicago Fed, she served as a Fellow at Brookings Metro, performing research and analysis on areas that include the racial wealth gap, the return to education investment, and the disparate economic impact of the COVID-19 pandemic. In addition, Broady has conducted research on mortgage foreclosure risk, labor and automation, and racial health disparities.

Broady is an adjunct professor of econometrics and statistics at the University of Chicago Booth School of Business and has served on the faculties of Spelman College, Alabama A&M University, Dillard University, Dominican University, Fort Valley State University, Howard University, Kentucky State University, and as a visiting faculty member at Jiangsu Normal University in Xuzhou, China. She served as a consultant for the Joint Center for Political and Economic Studies in Washington, D.C.; a senior research fellow for the Center for Global Policy Solutions in Washington, D.C.; a consultant for the City of East Point, Georgia and as an HBCU consultant for season two of The Quad on Black Entertainment Television (BET) in Atlanta. Broady earned a B.A. in criminal justice at Alcorn State University and an M.B.A. and Ph.D. in business administration with a major in economics at Jackson State University.

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Panelist

James Capretta

Milton Friedman Chair
American Enterprise Institute

James Capretta is a senior fellow and holder of the Milton Friedman Chair at the American Enterprise Institute (AEI), where he studies health care, entitlement programs, and fiscal trends in advanced economies. Capretta concurrently serves as a senior adviser to the Bipartisan Policy Center, and he has also served as a member of the advisory board of the National Institute for Health Care Management Foundation since 2011.

He spent more than 16 years in public service before joining AEI. As an associate director at the White House’s Office of Management and Budget from 2001 to 2004, he was responsible for all health care, Social Security, welfare, and labor and education issues. Previously, he served as a senior analyst at the U.S. Senate Budget Committee and the U.S. House Committee on Ways and Means. Before joining AEI full-time, Capretta was affiliated with other national think tanks.

Capretta is the author of US Health Policy and Market Reforms: An Introduction (AEI Press, 2022), and several book chapters, including “Fiscal rules for Social Security and Medicare: Would accrual accounting help?” in Public Debt Sustainability: International Perspectives (Lexington Books / Rowman & Littlefield Publishing Group Inc., 2022), and with Joseph Antos, “The road not taken” in The Trillion Dollar Revolution: How the Affordable Care Act Transformed Politics, Law, and Health Care in America (Public Affairs, 2020).

A contributor to RealClearPolicy, Capretta has testified before Congress and published many essays and reports since leaving government service in 2004. He earned an MA in public policy studies from Duke University and a BA in government from the University of Notre Dame.

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Speaker

Lydia DePillis

Reporter
New York Times

Lydia DePillis joined the New York Times in 2022 as a reporter covering the American economy. In her role, DePillis closely studies various data and research indicating the health of the U.S. economy, the status of American workers and businesses, and how public policy affects them. She has a particular interest in the ways climate change is warping everything from agriculture to the financial system, the shifting bargaining power of American labor, and why cities and regions grow or shrink. While much of her work is explanatory in nature, she also considers that part of her job is to expose wrongdoing and hold those with power to account.

Following her graduation from Columbia College in 2009, DePillis worked for several news outlets prior to joining the New York Times. She reported on topics at various newspapers that helped her to understand the many corners of the economy: real estate and land use at the Washington City Paper, technology at the New Republic, labor and finance at the Washington Post, and the energy industry at the Houston Chronicle. DePillis first handled the national economy while writing for CNN, and she then learned investigative techniques while covering federal agencies at the nonprofit investigative newsroom ProPublica.

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Panelist

Anthony LoSasso

Professor, Driehaus Fellow, and Chair of the Department of Economics
Driehaus College of Business at DePaul University

Anthony LoSasso is a professor, Driehaus Fellow, and chair of the Department of Economics at the Driehaus College of Business at DePaul University. He is an economist whose research spans several dimensions of health and labor economics, health policy, and health services and outcomes research.

LoSasso is keenly interested in how government policies affect private sector decisions. After receiving an Agency for Healthcare Research and Quality (AHRQ) Five-Year Independent Scientist Award entitled “Workplace Health Benefits and Employee Health,” LoSasso’s research explored the impact of the State Children"'s Health Insurance Program on insurance among children and the extent to which public coverage may have “crowded out" private coverage of children, how community rating provisions in state health insurance markets affect health insurance coverage, and how the availability of safety net health care services affects the willingness of firms to offer health insurance and the willingness of employees to take up health insurance when it is offered.

An area of particular interest for LoSasso is the effects of health insurance benefit design on health care utilization and health outcomes. This work includes an AHRQ-funded research grant to study so-called narrow network insurance plans; a National Institute of Mental Health (NIMH)-funded study to examine the impact of an expansion of mental health benefits on cost and quality of care at a large manufacturing firm; and ongoing work examining the effects of high deductible health insurance on health care use.

LoSasso was appointed by the governor to the State of Illinois’s new Medicaid Managed Care Oversight Commission. The commission evaluates the effectiveness of Illinois’s managed care program. LoSasso will serve as an academic expert on the Medicaid managed care program.

Additionally, LoSasso has served as co-investigator on an NIH-funded study examining the effects of corporate wellness programs on the use of preventive services and health outcomes. With training in labor and health economics and extensive experience studying the effects of insurance in both the private and public sectors, LoSasso is a nationally recognized leader in the field.

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Panelist

Angela Harper Mahome

Psychiatrist
Montrose Behavioral Health Hospital

Angela Harper Mahome is a child and adolescent psychiatrist who has spent most of her professional career working in Chicago and its southwest suburbs. Her interest in insurance coverage began during her high school years when she worked at her father’s orthopedic practice in Atlanta, Georgia. She completed her undergraduate degree at Spelman College before attending medical school at the Medical College of Georgia. Mahome then completed her residency in general psychiatry and fellowship in child and adolescent psychiatry at the University of Chicago Hospitals. She currently works as an inpatient psychiatrist at Montrose Behavioral Health Hospital for Children, and also serves as a consultant for Danville School District 118. With more than 20 years of experience, Mahome has worked in various clinical settings, including an inner-city mental health center and a safety-net hospital, that relied on reimbursements from Medicare and Medicaid. Mahome has also worked in private settings where patients had premium insurance plans or the means to pay for their care out-of-pocket.

Angela Harper Mahome is a child and adolescent psychiatrist who has spent most of her professional career working in Chicago and its southwest suburbs. Her interest in insurance coverage began during her high school years when she worked at her father’s orthopedic practice in Atlanta, Georgia. She completed her undergraduate degree at Spelman College before attending medical school at the Medical College of Georgia. Mahome then completed her residency in general psychiatry and fellowship in child and adolescent psychiatry at the University of Chicago Hospitals. She currently works as an inpatient psychiatrist at Montrose Behavioral Health Hospital for Children, and also serves as a consultant for Danville School District 118. With more than 20 years of experience, Mahome has worked in various clinical settings, including an inner-city mental health center and a safety-net hospital, that relied on reimbursements from Medicare and Medicaid. Mahome has also worked in private settings where patients had premium insurance plans or the means to pay for their care out-of-pocket.

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Speaker
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Opening Remarks

Anna Paulson

Executive Vice President, Director of Research and Executive Committee Member
Federal Reserve Bank of Chicago

Anna Paulson is executive vice president and director of research at the Federal Reserve Bank of Chicago. She leads the Bank’s research and policy analysis work, overseeing the department that provides analytic support for monetary policymaking and conducts research on banking and financial markets, macroeconomics, microeconomics, and regional economics. Paulson also has responsibility for the Bank’s Public Affairs and Community Development and Policy Studies departments. She attends meetings of the Federal Open Market Committee (FOMC), the group responsible for formulating the nation’s monetary policy, and serves on the Bank’s Executive Committee.

Paulson is an expert on financial markets and institutions, with particular expertise on the insurance industry. Her research investigates how households and firms adapt to incomplete financial markets and how household financial decision-making is influenced by exposure to institutions and economic events, including financial crises. Paulson’s research has been published in leading scholarly journals, including the Journal of Political Economy, Review of Economics and Statistics, and Review of Financial Studies. She is a past board member of the Western Economic Association International and a current board member of the American Economic Association’s Committee on the Status of Women in the Economics Profession. Paulson received a Bachelor of Arts from Carleton College and a PhD in economics from the University of Chicago.

Paulson joined the Chicago Fed as an economist in 2001 after serving as an assistant professor of finance at the Kellogg School of Management at Northwestern University. In 2009 she was promoted to vice president in the Financial Markets Group and established the Insurance Initiative, which analyzes financial stability and regulatory issues in the insurance industry on behalf of the Federal Reserve System. She became associate director of research in 2017 and was promoted to director of research in 2019.

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Speaker

Shanthi Ramnath

Senior Economist and Economic Advisor
Insurance Initiative and Financial Economics
Federal Reserve Bank of Chicago

Shanthi Ramnath is a senior economist and economic advisor in the research department at the Federal Reserve Bank of Chicago and a member of the Chicago Fed’s Insurance Initiative. In that role, she works on topics related to insurance and its impact on household decision making. Her research has been published in journals like the American Economic Journal, the Journal of Public Economics, and Brookings Papers on Economic Activity.

Before joining the Chicago Fed, Ramnath was a financial economist in the Office of Tax Analysis at the U.S. Department of the Treasury. Ramnath has a Ph.D. in economics from the University of Michigan.

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Panelist

Robin Rudowitz

Vice President and Director
KFF

Robin Rudowitz is vice president at KFF and director of the Program on Medicaid and the Uninsured, where she oversees all work on Medicaid, the Children’s Health Insurance Program (CHIP), and low-income populations including coverage, eligibility, financing, delivery systems, access and long-term services and supports. Prior to joining KFF in 2004, Rudowitz was a senior manager at the Lewin Group, a health policy and management consulting firm. Rudowitz has worked on budget and health policy issues in various government agencies, including the Office of Legislation at the Centers for Medicare & Medicaid Services, Office of the Chief Financial Officer for the District of Columbia, Congressional Budget Office, and Ways and Means Committee for the New York State Assembly.

Rudowitz holds a bachelor’s degree in policy analysis and a master’s degree in public administration from Cornell University.

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