Essays on children's health insurance

The past two decades have witnessed massive policy efforts targeted at reducing the proportion of uninsured low-income children. This dissertation provides new evidence on the impact of these expansions on the insurance coverage of their target population. It also estimates the effects of insurance coverage on children's access to medical care and health care utilization.;The first essay examines the effects of recent Medicaid expansions on the insurance coverage of poor teenagers, a population that has received considerably less research attention than its younger peer group. I exploit the presence of age discontinuities in Medicaid eligibility thresholds across states as a natural experiment with which to identify the plausibly causal effects of the expansions. I find that the expansions greatly increased public coverage among the population of interest and that the take-up of public coverage came from both the previously uninsured and the previously privately insured.;The second essay examines the effects of public and private coverage on health care utilization and access to care outcomes among children. It uses instrumental variables techniques to parse causal effects from confounding influences. The major innovation of this essay is its use of a new instrument: a measure that captures the variation across states of the administrative burden associated with Medicaid enrollment and recertification. Results suggest that both public and private coverage have large effects on access to care and medical care receipt.;The third and final essay is an examination of the dose-response relationship between insurance coverage and utilization outcomes. The modal uninsured experience of children is one of a relatively short duration; however, very little is known about whether short uninsured spells influence care receipt over a longer time period. The primary contribution of this essay is its provision of estimates on the relationship between the duration of coverage over the course of a calendar year and health care utilization. Using child-level fixed effects models, I find that an incremental uninsured month is associated with a decrement in care receipt, suggesting that short gaps without coverage may indeed jeopardize children's access to medical care.