The union advantage: union membership, access to care, and the Affordable Care Act.

We describe a "union advantage" in health insurance coverage and access to care. Using multiple statistical models and data from the Medical Expenditure Panel Survey for 1996-2019, we show that-compared to non-union workers-union workers are more likely to have health insurance coverage (98% vs. 86%), more likely to have a regular care provider (83% vs. 74%), visited office-based providers 31% more often (5.64 vs. 4.27 visits), spend $832 more on healthcare annually, and pay a lower share of their expenditures out-of-pocket (26% vs. 37%). When we control for demographic characteristics across variety of specifications, these differences almost always remain at a statistically significant level. Further, we show that the union advantage is greater for low-income workers. Next, we demonstrate that-although the Affordable Care Act (ACA) appears to have reduced the union advantage in health insurance coverage by increasing coverage rates among non-union workers-a substantial union advantage in access to care remains after the ACA's main provisions become effective. Finally, we explore how the ACA interacted with the trade union  goal of maintaining employer-based health insurance. We show that unionized workers are less likely to contribute to "enrollment shifting," which occurs when individuals shift from existing employer-based insurance to a new government funded program. This suggests that union bargaining over fringe benefits may have positive externalities in the form of cost reductions to the public sector.

A Tullock Index for assessing the effectiveness of redistribution.

I propose two alternative versions of a "Tullock Index" for assessing the effectiveness of income or wealth redistribution. In the spirit of Atkinson's (J Econ Theory 2:244-263, 1970) inequality index, the Tullock Index is constructed with reference to either (A) the maximum inequality reduction attainable with current transfer spending or (B) the minimum transfer spending necessary to achieve current post-transfer inequality. Using Current Population Survey (CPS) microdata from 1988 to 2014, I construct annual estimates of the Tullock Index at the national level for the United States. The Tullock Index is increasing over that period, suggesting that redistribution has become less effective in reducing inequality. State-level panel fixed-effects estimates show that ineffective redistribution is related to higher state-level poverty rates, lower employment-to-population ratios, and lower levels of overall employment.