In virtually all areas of the U.S. healthcare service sector, physicians are barred from referring patients to entities in which they have an ownership stake. But this is not the case for the dialysis industry, which is exempt from such restrictions. Joint ventures between physicians and dialysis facilities exist at nearly 20 percent of facilities. This research will explore how physicians’ ownership ties with dialysis firms affect steering, spending, and outcomes. Using data obtained from a Freedom of Information Act request from the Centers for Medicare and Medicaid Services, Eliason, McDevitt, and Roberts will construct a first-of-its-kind dataset that tracks the ownership of dialysis facilities, including whether physicians have an ownership stake. They will add in data on dialysis providers and patients, including detailed Medicare claims and rich information on patient characteristics and health outcomes. An event-study analysis will allow the three researchers to test whether there is a clear trend-break in new patient arrivals and referrals when parties enter into a joint venture in order to examine how integration affects competition. The analysis will enable the researchers to study how patient caseloads and referrals at unintegrated facilities change after a nearby rival forms a joint venture, along with the impact of vertical integration on patient outcomes such as hospitalizations and mortality, as well as overall Medicare spending. Prior research has found that Black, Latinx, and low-income patients suffer disproportionately from kidney failure and often receive worse care, potentially making these groups especially vulnerable to providers’ growing market power and physicians’ conflicting interests.

Manufacturing jobs in the United States were widely considered to provide an important opportunity for less-educated workers to climb the U.S. economic ladder by offering high pay and stable careers. Research shows that the decline in manufacturing jobs since the 1970s coincided with a decline in upward mobility: Children born in the 1980s are less likely to grow up to earn as much as their parents than children born in the 1950s were, particularly in the post-industrial heartland. This project examines how increases in high-wage manufacturing work opportunity affected individual opportunity following the industrial mobilization for World War II. Garin and Rothbaum will exploit the fact that the siting of new plants was based on idiosyncratic short-run strategic considerations, leading to the construction of massive new publicly financed manufacturing plants in places that would not have been chosen by private firms. This historical dynamic gives rise to an ideal laboratory for studying how public investments that create high-wage employment impact upward mobility in the long run. The authors have digitized data on the locations of World War II manufacturing facilities using the War Production Board data books. Focusing on children who grew up in those areas in the 1940s, the two researchers will then trace those individuals’ income trajectories using the later-20th century Current Population Survey data linked to Social Security Administration-based income histories to examine mobility rates.

U.S. unemployment due to the onset of the coronavirus pandemic was widespread, as was U.S. economic insecurity. In terms of consumption, aggregate retail sales fell by 16 percent in April 2020, the largest fall on record. While retail spending recovered by mid-July, spending on services remained significantly depressed. In contrast to aggregate spending and U.S. labor market data, there is little real-time data on the impact of the coronavirus pandemic on consumer spending inequality. This project will use a new transaction-level, real-time dataset from Earnest Research to measure consumer spending inequality in the United States and assess the impact of the pandemic on consumption inequality. The dataset contains information on a panel of 6 million households and is updated with a delay of just 1 week. Abdelwahed and Robbins will be able to study the outflows of spending, as well as the inflows of payments from wages and salaries, stimulus payments, and other government transfers into the households’ accounts, allowing them to construct a series on various ratios of spending between the top and bottom percentiles in order to study changes in consumer spending inequality along the distribution. They will also measure the effects of the pandemic on consumption of those who lost their jobs or experienced lower incomes and will compare them to individuals who retained their jobs. Abdelwahed and Robbins will estimate the impact of government stimulus payments and Unemployment Insurance on consumer spending inequality and consumption patterns. The data will be released publicly at the aggregate level at both the state and county levels, and the two researchers plan to release quarterly reports, providing other researchers and policymakers with a valuable new data source.

This project examines the source of racial and ethnic inequality among the highly educated workforce in the United States by focusing on how educational credentials translate into U.S. labor market outcomes. The racial and ethnic wage divide is the largest and has expanded the most among highly educated workers, despite the fact that people of color in the United States are registering higher educational attainment. This project seeks to shed light on that by exploring how educational credentials translate into positions in the U.S. labor market and whether there are mismatches. Specifically, the project will investigate vertical and horizontal dimensions of education-occupation mismatches. Vertical mismatch refers to a mismatch between a worker's educational credentials and the level of education required for the occupation, such as a college graduate working as a retail sales associate. Horizontal mismatch refers to a mismatch between a worker's field of study and the type of education required for the occupation, for example, an engineering major working as an accountant. Lu will incorporate a demand-based measure of mismatch using online job-posting data compiled by Burning Glass Technologies, in addition to pooling two decades of nationally representative longitudinal data from the Survey of Income and Program Participation. She will investigate which dimensions of mismatch and which processes in the employment relationship drive racial and ethnic labor market inequality by exploring initial occupational allocation, subsequent occupational trajectory, and wage consequences of mismatch. Lu also will investigate how educational stratification factors into ethnic/racial disparities by looking at degree levels, fields of study, and college quality.

An estimated 7.5 million children under 6 years old are cared for by home-based child care providers each year, which represents the majority of young children in regular nonparental care arrangements in the United States. Home-based child care programs are more affordable and accessible to a broad range of families, especially low-income, Black and Latinx, and rural families. The pandemic has drawn attention to longstanding racialized inequities in access to child care and the structural inequalities that are perpetuated due to insufficient investment in the home-based child care sector. This project will document trends over time (before, during, and after the pandemic) in access to child care subsidies for home-based care providers using administrative records data for the state of Illinois, paying particular attention to the racial composition of those receiving child care subsidies and those who serve racially diverse and economically disadvantaged families through the child care subsidy program. The analysis of the administrative records will be able to show how licensed and unlicensed providers' access to child care subsidies were affected by the pandemic, compared with one another and compared with center-based care. The two researchers will augment this analysis with in-depth interviews with home-based care providers. These qualitative interviews will explore how home-based care providers fared during the pandemic.

Progressive taxation is highly polarized in the United States because some states have millionaire taxes while others have no state income tax at all. The 2017 tax reform legislation, the Tax Cuts and Jobs Act, amplified these differences by capping the state and local tax, or SALT, deduction. This effectively reduced top tax rates in some states while increasing them in others, leading some, including governors, to worry that this new tax differential will set off a wave of millionaire tax flight and a new “race to the bottom” in state taxes on the rich. Using confidential data from IRS tax returns, the author will examine elite mobility and embeddedness in the wake of the 2017 tax reform. The author seeks to understand if the rich are more likely to move when their tax rates are high, whether the TCJA-induced tax differential led to greater migration, and, conditional on moving, how much this tax reform increased the likelihood that moves are to lower-tax destinations. These questions are of great importance as state and local taxes are essential for states’ capacity to provide services and alleviate inequality. And while previous work shows the existence of effects among particular job classes, this paper would provide policy-relevant estimates for the universe of high-earners in recent U.S. history.