Research

Working Papers

Impact of Medicaid Pregnancy Dental Benefits on Prenatal Dental Utilization and Birth Outcomes
Job Market Paper
with Qian X, Bruckner T, Manski R, Steenland M, Lipton B

Despite elevated risks for oral health problems, more than half of pregnant women do not visit the dentist at least once during pregnancy. The Medicaid program covers more than 40% of US births and represents an important source of pregnancy dental coverage. We examine the effects of state-level pregnancy dental benefits using a difference-in-differences approach and data from the 2012-2019 Pregnancy Risk Assessment and Monitoring System (PRAMS). We find that providing dental coverage to pregnant Medicaid recipients increases dental cleaning rates by 7.16 percentage points, or 29% relative to baseline. We also examine linked birth certificate data given evidence that poor oral health during pregnancy is associated with adverse pregnancy and birth outcomes. We find evidence of reductions in small for gestational age and very low birth weight, though results are somewhat sensitive to specification and data source. An analysis of mechanisms suggests that Medicaid dental benefits increase rates of pregnancy dental insurance, increase receipt of dental counseling, and improve self-reported general health status.

Impact of Medicaid Dental Coverage Expansion on Dental Care Utilization and Smoking Behavior Among Reproductive-Age Women
with Qian X, Bruckner T, Manski R, Steenland M, Lipton B

Dental care utilization among reproductive-age women not only affects their oral and overall health but also influences other health behaviors, with potential intergenerational implications. This study examines the effects of Medicaid dental coverage expansion for non-pregnant adults on dental care utilization and behavioral outcomes among reproductive-age women (21-44 years old) using data from the Behavioral Risk Factor Surveillance System (2000-2022). Exploiting state-level variations in dental benefit policies, we employ a difference-in-differences strategy to estimate the impact of expanded coverage. Our findings indicate that Medicaid dental benefit expansions increase the likelihood of dental care utilization by 4.8 percentage points, an 8.6% increase from the baseline rate. However, we also find evidence of potential moral hazard, as expanded coverage is associated with higher probabilities of smoking initiation and frequent

The Effect of Paid Sick Leave Mandates on Social Security Disability Claims
with Qian X, Dave D, Kim J, Lipton B, Sabia J

Paid sick leave mandates (PSLs), which have been adopted by 18 states and the District of Columbia, require employers to provide regular wages when workers take short-term leave for their own or a family member’s medical needs. This study is the first to explore the effects of PSL adoption on participation in the Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) programs, as well as the health of persons with disabilities. We find that statewide PSLs are associated with a 6-9 percent increase in initial claims for SSI and joint SSI/SSDI benefits. These applications translate to an increase in beneficiaries, strongest among children under age 18. An exploration of the mechanisms underlying this result reveals PSL-induced (1) increases in time spent offering informal caregiving of those with disabilities, which may reduce the costs of applying to SS(D)I programs, and (2) small reductions in work hours, reflecting either higher costs of labor to employers or some workers substituting to fewer work hours and more caregiving. Finally, we find that PSL mandates lead to modest improvements in healthcare use and health among individuals with disabilities.

When Parents Can Take Time: Paid Sick Leave and Child Mental Health
with Khalid S

Children’s mental health challenges have risen sharply in the United States, yet structural barriers such as parental work constraints continue to limit access to timely care. This paper provides new causal evidence that Paid Sick Leave (PSL) mandates improve children’s and adolescents’ mental health. Following the adoption of PSL laws, the likelihood that a child receives any mental health care increases by 1.2 percentage points (a 10% rise relative to the baseline mean), while parent-reported depression diagnoses increase by 0.4 percentage points (7%). Complementary evidence shows that PSL mandates reduce youth depressive symptoms by 1.6 percentage points (5.3%) and suicidal ideation by 1.1–1.4 percentage points (7–10%). Mechanism analyses suggest that these improvements operate primarily through enhanced parental time flexibility rather than changes in insurance coverage or financial strain. Overall, the findings highlight the broader public health benefits of labor protections that enable working parents to support their children’s mental health.

Work in Progress

Impact of Telehealth Policy Expansion on Substance Use Treatment: A State-Level Longitudinal Analysis
with Masoumirad M

Policy Implications of Hearing Aid Coverage in Medicaid Managed Care Plans
with Tonti L, Arnold M, Lipton B

Statewide Transparency of Medicaid Vision Benefits: An Assessment of Adult Managed Care Plans in 2024
with Patel N, Hsieh T, Lipton B