Dissertation, Columbia University (
2020)
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Abstract
This dissertation aimed to examine the consequence of health-induced poverty and two
policy responses to address this issue among older adults in the United States and China.
Specifically, Paper I investigates whether public transfers crowded out private transfers among
rural and urban Chinese older families and if this dynamic would change when health care
expenses were high. Paper II examines the effect of New Rural Cooperative Medical Insurance, a
national health insurance program for rural residents in China, on changing the incidence of
health-induced poverty among middle-aged and older beneficiaries. Paper III tests the effects of
closing the Medicare Part D donut hole (coverage gap) through the Affordable Care Act (ACA)
on changing prescription drug cost-induced poverty. Overall, the findings obtained from these
three papers provide empirical evidence that health-induced poverty is prevalent among older
adults in both China and the United States and the current public transfers and health policies are
either ineffective or insufficient to reduce health-induced poverty as intended.