“Health Care Reform and Firm Dynamics: Evidence from Medicare Part D and the Retail Pharmacy Industry” with Brandyn F. Churchill and Kelli Marquardt. NBER WP No. 35380.

Health care reforms are often enacted before implementation, creating uncertainty that can shape firms’ decisions. We examine how Medicare Part D affected the retail pharmacy industry using 2000-2009 establishment-level data, leveraging the fact that Part D disproportionately affected counties with larger elderly populations. Consistent with predictions from a conceptual model in which pre-implementation uncertainty discourages entry and lower post-implementation margins prevent full recovery, we find that Part D was associated with a 5-percent reduction in pharmacies, driven by fewer openings rather than more closures. We also find suggestive evidence that reduced pharmacy access dampened Part D’s mortality benefits.

“SNAP Purchasing Power and Household Time Allocation”

SNAP benefits are set uniformly across the contiguous United States, but geographic variation in food prices creates substantial disparities in the program’s real purchasing power. This paper exploits this variation using a triple-difference strategy that compares SNAP-eligible to near-eligible households across 35 local markets. A 10-percent increase in SNAP purchasing power was associated with a 7-percent reduction in daily purchasing time and a 4-percent increase in leisure time, with no meaningful results on market work, home production, childcare, or sleep. Heterogeneity analysis reveals that these associations differ by gender and parental status. These findings suggest that geographic disparities in benefit adequacy affect not only what households can purchase but how they allocate their time.

“Does Food Assistance Drive Spending on Sugary Foods? Evidence from the Pandemic Electronic Benefit Transfer Program” with Brandyn F. Churchill

Although it is unclear whether food assistance contributes to lower diet quality among recipients, policymakers are actively working to restrict SNAP-eligible purchases of items high in added sugars. We provide timely evidence on the extent to which food assistance increases spending on sugary items by studying the Pandemic Electronic Benefit Transfer (P-EBT) program, which provided food assistance benefits to families of children who lost access to free and reduced-price school meals due to COVID-19 pandemic school closures. Leveraging state-level variation in the timing of P-EBT disbursements and using a stacked difference-in-differences identification strategy with NielsenIQ Consumer Panel data, we find that P-EBT disbursement was associated with a 16-percent increase in weekly spending on sugary items among SNAP-eligible households with school-aged children. Notably, this increase exceeded the percentage increase in overall food spending for this group, suggesting that SNAP-eligible households with school-aged children allocated a disproportionately large share of their P-EBT-driven purchases toward sugary items relative to their pre-period baseline. We do not detect changes among households unlikely to have received P-EBT benefits or in placebo disbursement years.