Tami Gurley-Calvez

Do tax rate cuts encourage entrepreneurial entry

Purpose – Policy makers have long been interested in whether tax policies can be used to encourage entrepreneurial activity, but prior studies have produced ambiguous results. The purpose of this paper is to investigate whether tax rates affect the decision to begin a new entrepreneurial venture. Design/methodology/approach – The paper uses a 12-year panel of tax return data to examine the effects of tax rates on entrepreneurial entry. The paper calculates household-level tax rates and employ multiple measures of entrepreneurship. Findings – The results offer evidence that cuts in relative tax rates faced by entrepreneurs, either in the form of higher rates for wage workers or lower rates for entrepreneurs, increase entry. The magnitudes of these effects suggest that an across the board tax cut would increase entry. Practical implications – These results suggest that policy makers interested in entrepreneurial activity should account for the affects of tax policies on entrepreneurial activity in their dec...

Active Versus Passive Choice: Evidence from a Public Health Care Redesign

This research examines how people choose among different public health insurance plans and assesses the factors that influence their choice. The authors explore two types of choice: active choice, in which consumers explicitly choose a plan, and passive/no choice, in which consumers take no action in choosing their plan. Using administrative and survey data for a sample of Medicaid recipients from a state that recently redesigned its Medicaid program, the authors identify what drives consumers’ choices using constructs loosely framed by classic motivation, opportunity, and ability models. The results show that when consumers engage in active decision making, there are few barriers to selecting a wellness-based health plan with greater prescription coverage. In addition, the findings suggest that it is important for informed people, such as health care professionals, to be involved in plan choice. Unexpectedly, Medicaid recipients who rely on word-of-mouth communication tend to avoid active choice.

Lactation Support Services and Breastfeeding Initiation: Evidence from the Affordable Care Act

OBJECTIVE Despite substantial evidence of the benefits of breastfeeding for both mothers and children, rates of sustained breastfeeding in the United States are quite low. This study examined whether mandated coverage of lactation support services under the Affordable Care Act (ACA) affects breastfeeding behavior. DATA SOURCE We studied the census of U.S. births included in the National Vital Statistics System from 2009 to 2014. STUDY DESIGN We used regression-adjusted difference-in-differences (DD) to examine changes in breastfeeding rates for privately insured mothers relative to those covered by Medicaid. We adjusted for several health and sociodemographic measures. We also examined the extent to which the effect varied across vulnerable populations-by race/ethnicity, maternal education, WIC status, and mode of delivery. PRINCIPAL FINDINGS Results suggest that the ACA mandate increased the probability of breastfeeding initiation by 2.5 percentage points, which translates into about 47,000 more infants for whom breastfeeding was initiated in 2014. We find larger effects for black, less educated, and unmarried mothers. CONCLUSIONS The Affordable Care Act-mandated coverage of lactation services increased breastfeeding initiation among privately insured mothers relative to mothers covered by Medicaid. The magnitude of the effect size varied with some evidence of certain groups being more likely to increase breastfeeding rates.

Federal Tax Policy and Small Business

Do entrepreneurs need tax reform? This chapter presents a critical evaluation of the desirability of tax incentives for small businesses. We discuss measurement issues in identifying entrepreneurs in publicly-available data and then describe recent trends in several measures gleaned from tax data. Entrepreneurial activity is on the rise as evidenced by a growing share of non-corporate entities among business tax returns. Small businesses represent a disproportional share of taxable profits when compared to their share of total business receipts. We then turn to a discussion of the current tax treatment of entrepreneurs, followed by a brief overview of recent economic research on entrepreneurial sensitivity to tax policies. Economic theory suggests that taxes can have ambiguous effects on transitions into or out of entrepreneurial activity, which leaves the determination of overall effects to empirical analysis. This leads us to a presentation of our recent analysis of a twelve-year panel of U.S. federal individual income tax returns to examine the effects of federal income and payroll taxes and state income taxes on entrepreneurial activity. Our focus in this new analysis is on the effects of tax rates on individual transitions into or out of some form of entrepreneurial activity.

Depreciation rules and small business longevity

Purpose - – When a small business purchases a capital asset, its cost for tax purposes is spread over the useful life of the asset through the process of depreciation. It has become common in the USA for policy makers to enhance depreciation rules in an effort to increase business investment in a less-costly manner than across-the-board marginal tax rate cuts. Indeed, short-term depreciation policies are often billed by policy makers as a way to save Americas small businesses. However, little is known about the actual effects of depreciation policies on small business activity. This paper aims to discuss these issues. Design/methodology/approach - – In this initial attempt to test the political claims regarding the importance of depreciation rules, the paper uses a 12-year panel of tax returns for Schedule C sole proprietors to empirically examine whether more generous depreciation policies influence small business activity at the extensive margin. Specifically, the paper estimates a series of multivariate models to explain sole proprietors’ decisions to remain in business as functions of their financial, demographic, and tax situations, including measures of the present discounted value (PDV) of a stream of tax deductions for depreciated capital under various rule structures. Findings - – Throughout the analysis, the authors are unable to find evidence that favorable depreciation rules lead to greater rates of entrepreneurial longevity among Schedule C sole proprietors. Originality/value - – Discrete choice results suggest that increases in the PDV of tax reductions from depreciation (e.g. depreciating the value earlier in the recovery period) might actually lead to higher probabilities of small business exit, while survival analysis finds no clear influence of depreciation on spells of small business activity.

The Association Between Social Stressors and Home Smoking Rules Among Women With Infants in the United States

OBJECTIVES We examined the role of social stressors on home-smoking rules (HSRs) among women with infants in the United States, with attention on the moderating role of smoking status and depression. METHODS We analyzed data for 118 062 women with recent births in the United States who participated in the Pregnancy Risk Assessment Monitoring System (2004-2010), which is a population-based surveillance data set. We fit multinomial logistic models to predict the odds of partial or no HSRs by a cumulative index of prenatal social stressors. RESULTS Compared with those with no stressors, mothers with high levels of social stressors had 2.5 times higher odds of partial or no HSRs. Smokers in the 1-2, 3-5, and ≥ 6 stressor categories were 9.0%, 9.6%, and 10.8% more likely to have partial or no HSRs, respectively. Under the highest levels of stress (≥ 6), nonsmokers were almost as likely as smokers to have partial or no HSRs. In addition, the effects of stress on HSRs were more pronounced for nonsmoker, nondepressed mothers. CONCLUSIONS Increases in social stressors represented an important risk factor for partial or no HSRs and might have potential negative implications for infants.

Effect of the Affordable Care Act on Breastfeeding Outcomes

Objectives To assess how the 2012 Affordable Care Act (ACA) policy change, which required most private health insurance plans to cover lactation-support services and breastfeeding equipment (without cost-sharing), affected breastfeeding outcomes. Methods We used a regression-adjusted difference-in-differences approach with cross-sectional observational data from the US National Immunization Survey from 2008 to 2014 to estimate the effect of the ACA policy change on breastfeeding outcomes, including initiation, duration, and age at first formula feeding. The sample included children aged 19 to 23 months covered by private health insurance or Medicaid. Results The ACA policy change was associated with an increase in breastfeeding duration by 10% (0.57 months; P = .007) and duration of exclusive breastfeeding by 21% (0.74 months; P = .001) among the eligible population. Results indicate no significant effects on breastfeeding initiation and age at first formula feeding. Conclusions Reducing barriers to receiving support services and breastfeeding equipment shows promise as part of a broader effort to encourage breastfeeding, particularly the duration of breastfeeding and the amount of time before formula supplementation.

Clinical trial insurance coverage for cancer patients under the Affordable Care Act

Background Participation in cancer clinical trials has been shown to increase overall survival with minimal increase in cost, but enrollment in adult cancer clinical trials remains low. One factor limiting enrollment is lack of insurance coverage, but this barrier should be reduced under the 2010 Patient Protection and Affordable Care Act (ACA), which includes a provision requiring coverage for clinical trial participation as of 2014. Methods To assess the number of Kansas adults aged 19–64, newly covered with health insurance for participation in oncology clinical trials as a result of the ACA, a cross sectional design using extracted data from the 2012 American Community Survey, Public Use Microdata Sample to estimate the number of individuals covered by insurance and data from the 2014 Department of Health and Human Services Health Insurance Marketplace enrollment to estimate those newly enrolled through ACA. Results In 2014, there was an estimated increase of 3% (54,397; 95% CI: 44,149–64,244) for a total of 72% (1,171,041) of Kansans aged 19 to 64 with health insurance coverage for clinical trial participation. Conclusion Three main factors limit the effectiveness of the ACA provisions in expanding clinical trial coverage: 1) ‘grandfathered’ self-funded employer plans not subject to state Employee Retirement Income Security Act (ERISA) regulations, 2) Medicaid coverage limits not addressed under the ACA, 3) populations that remain uninsured. Kansas saw a negligible increase in insurance coverage as a result of the ACA thus lack of insurance coverage is likely to remain a concern for cancer patients.

Effect of Obesity on Breastfeeding

INTRODUCTION: Obesity presents mechanical challenges and may reduce breastfeeding rates. We examined the relationship of obesity and breastfeeding, adjusting for factors that are known to affect breastfeeding. METHODS: This is a retrospective cohort study using survey data (2009–2010) from the Pregnancy Risk Assessment Monitoring System. The outcome was breastfeeding at any time (breastfeeding ever). Independent variables included maternal smoking, age, race, education, depressed mood, gestational age (preterm or term), and stressful life events. RESULTS: Of 66,508 women, 79% had ever breastfed. Fewer women in the underweight, overweight, and obese body mass index (BMI) groups ever breastfed compared with normal BMI groups (77% compared with 79% compared with 75% compared with 81%, respectively, P<.001). On multivariable logistic regression, the odds (odds ratio, 95% confidence interval) of ever breastfeeding were significantly lower for the obese compared with normal BMI, 0.84 (0.76–0.92). Smoking, African American race, preterm delivery, depressed mood, and public insurance were associated with lower odds of ever breastfeeding. CONCLUSIONS: Obesity significantly reduces a womans chances of ever breastfeeding. Therefore, identification of obesity as a high-risk groups for not breastfeeding may assist clinicians in designing future interventions.

Entrepreneurs, Financial Risk and Wealth

Using 1989 to 2007 Survey of Consumer Finances data, this paper addresses three questions: 1) Are entrepreneurs are generally more or less financially conservative than their non-entrepreneurial counterparts? 2) Do entrepreneurs accumulate more wealth? and 3) Do entrepreneurs hold a smaller share of their financial assets in risky stock holdings? Results indicate that entrepreneurs are financially conservative based on borrowing and savings questions but are more likely to assume risk for financial gain. Consistent with earlier evidence that entrepreneurs save more, they also accumulate more wealth over time. Entrepreneurs and non-entrepreneurs invest similar shares of their financial portfolios in safe assets. Taken together, the results suggest that policies aimed at increasing entrepreneurship should focus on helping households identify high-value business opportunities through transparent tax, legal, and regulatory systems. Efforts to reduce entrepreneurial risk should focus on the business venture, such as full loss offsets, rather than focusing on reductions in other financial risks.