UC San Diego

This dissertation is composed of three chapters addressing the economics of health, discrimination, and inequality.

The first chapter examines the roles of the Affordable Care Act (ACA) and employer spousal coverage made possible by same-sex marriage in increasing health insurance coverage for same-sex couples in the United States. It uses data from the American Community Survey in a difference-in-differences model on same-sex couples in ACA Medicaid expansion states to determine if people who did not have access to legal same-sex marriage at the time of the ACA had larger gains in insurance coverage post-ACA than those who already had access to marriage. I find a 1.8pp larger increase in Medicaid coverage and a 3.5pp larger increase in overall coverage in late gay marriage states. These differences are the combined effects of the initial differential response to the ACA and the subsequent direct response to same-sex marriage passage in the post period. When I directly control for same-sex marriage passage, I find a 2.8pp larger increase in Medicaid and suggestive evidence for increased crowd-out of employer coverage in late gay marriage states.

The second chapter explores the link between homophobic attitudes and the wage gap between men in same-sex couples and men in opposite-sex couples in the US. I use average responses to General Social Survey questions to create a state-year level prejudice index and show that it has a positive relationship with the wage gap. An increase of one standard deviation in the homophobia index is associated with a 4% wage penalty for men in same-sex relationships.

In the third chapter, we examine taxation of diapers, usually seen as an inelastic health product, and find substantial income heterogeneity in responsiveness to taxes using retail scanner data. Exploiting changes to sales tax exemptions for diapers in New York and Connecticut, we find that diaper sales rise by 5.4% in low-income areas when taxes are removed, accompanied by reduced spending on children's pain medications. These results imply that sales tax exemptions for diapers can have positive spillover effects on health and well-being.