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Welcome from the Director

Joe SabiaThe Center for Health Economics & Policy Studies (CHEPS) is an interdisciplinary research center that supports impactful, policy relevant scholarship in the areas of health economics and social policy analysis. Housed in the College of Arts & Letters, CHEPS brings together faculty and graduate students engaged in complementary research in the areas of national defense policy, economic demography, the economics of crime and punishment, and the economics of risky health behaviors.  Read more>>

Read the CHEPS Magazine 2026

Past issues of the magazine: 2025 | 2024 | 2023 | 2022 | 2021 | 2020 | 2019 | 2018

 

CHEPS Pioneering Research

 


Featured Research

Affordable Care Act ACAThe Long-Run Effects of the Affordable Care Act: Evidence from a Partially Pre-Committed Research Design Over the COVID-19 Recession and Recovery

A new study, released in May 2026 as an NBER Working Paper by Jeffrey Clemens, Anwita Mahajan, and Joseph J. Sabia, provides fresh evidence on the long-run effects of the Affordable Care Act (ACA), leveraging a partially pre-committed research design that extends earlier short-run analyses into the COVID-19 recession and recovery period. 

Contrary to expectations that pandemic-related labor market disruptions would amplify the ACA’s impacts, the authors find that its effects on insurance coverage and employment remained largely stable over time. 

Long-run changes in employment and employer-sponsored coverage are modest and significantly smaller than initially projected, suggesting that early concerns about large labor market distortions may have been overstated.

Beyond its substantive findings, the study also highlights the value of partially pre-committed research designs in producing credible long-term policy evaluations while minimizing risks of specification searching.


School Vaping Bans and Youth E-Cigarette Use
back pack with pencils and vape device

This study by Dhaval M. Dave, Jooyoung Kim, Nikolaos Prodromidis, and Joseph J. Sabia examines whether school-based vaping restrictions reduce youth use of electronic nicotine delivery systems (ENDS). As 40 states and the District of Columbia have implemented bans on vaping in K–12 schools, the authors use multiple nationally representative datasets and a generalized difference-in-differences approach to evaluate their impact. The findings show little evidence that these school-specific restrictions meaningfully reduce youth vaping, ruling out declines larger than 3.5 percent. Descriptive patterns suggest that students may instead adapt by switching to less detectable devices or vaping in concealed locations such as bathrooms and locker rooms.

In contrast, the study finds that broader, comprehensive vaping restrictions—extending beyond schools to workplaces, restaurants, and drinking establishments—are associated with a 1.5–2.6 percentage-point reduction in teen vaping, particularly by reducing initiation. These results indicate that while school-only policies may have limited effectiveness, more comprehensive, place-based restrictions that raise the overall cost of vaping are more successful in curbing youth use.


Do Informal Social Markets and Online Sellers Help Youth to Avoid E-Cigarette Taxationpeople using e-cigarettes

This study by Chad D. Cotti, Dhaval M. Dave, Tessie Krishna, Erik T. Nesson, and Joseph J. Sabia examines how electronic nicotine delivery system (ENDS) taxes influence not only youth vaping behavior but also how young people obtain e-cigarettes. Because more than 70 percent of underage users acquire vapes through social sources—such as friends, family, or acquaintances—rather than direct retail purchases, the effectiveness of taxation may be limited through these informal channels. Using data from the Youth Risk Behavior Surveillance System (YRBSS) and a difference-in-differences framework, the authors analyze how ENDS taxes affect both vaping prevalence and sourcing patterns among youth.

The findings show that ENDS taxes do reduce the likelihood of youth vaping and significantly decrease the probability that youths obtain e-cigarettes directly from stores. These results are supported by a range of robustness checks and alternative data sources. The authors suggest that taxes may also indirectly affect social supply channels, as third-party sellers or lenders may raise prices or become less willing to share devices when taxes increase. Together, the evidence indicates that while informal access remains important, ENDS taxation can still meaningfully reduce youth vaping through both direct and indirect mechanisms.


Do Vaping Taxes Tip the Scale? scale

With obesity affecting nearly three in four U.S. adults and about one in three children, researchers continue to explore policy approaches to address this ongoing public health challenge. One area of interest is the link between nicotine use and body weight. While nicotine can suppress appetite, traditional smoking carries serious health risks. The rise of Electronic Nicotine Delivery Systems (ENDS), such as e-cigarettes, has offered a potentially less harmful alternative, but also raised concerns about youth use, leading many states to impose taxes on these products. A recent study by Charles Courtemanche, Yang Liang, Anthony Chuo, Tessie Krishna, and Joseph J. Sabia investigates whether such taxes might have unintended consequences for weight outcomes.

sing nationally representative data from the Youth Risk Behavior Surveillance System (YRBSS) and the Behavioral Risk Factor Surveillance System (BRFSS), the researchers find that higher ENDS taxes are not associated with increased obesity. Instead, they are linked to modest but statistically significant reductions in body weight, particularly among females. A one-dollar-per-milliliter tax increase corresponds to a 1–2 percentage-point decline in obesity among female youth, with smaller but meaningful effects among adult women. At the same time, results for males are less pronounced and not statistically significant.  The authors suggest these patterns may reflect behavioral shifts, including substitution toward cigarettes and reductions in alcohol and marijuana use, both of which are often associated with poorer diet and weight gain.


More Research

This study by Anwar Assamidanov, Dhaval M. Dave, Jooyoung Kim, Brandy Lipton, Xuechao Qian, and Joseph J. Sabia examines the broader impacts of paid sick leave mandates (PSLs), now adopted in 18 states and the District of Columbia. While these policies are designed to support workers facing short-term health needs, the authors explore their effects on participation in federal disability programs—specifically Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI)—as well as health outcomes among individuals with disabilities.

The findings suggest that PSL adoption is associated with a 6–9 percent increase in initial applications for SSI and combined SSI/SSDI benefits, with the largest effects observed among children under 18. This increase in applications appears to translate into more beneficiaries, potentially driven by greater availability of informal caregiving and increased healthcare utilization, both of which may lower barriers to applying for assistance. While there is limited evidence of reductions in work hours—primarily among spouses of individuals with disabilities—the study also documents modest improvements in health outcomes for both children and adults with disabilities, highlighting important downstream benefits of expanded access to paid leave.

This study by Barış K. Yörük, Joseph J. Sabia, Tessie Krishna, and Dhaval M. Dave examines the effects of repealing alcohol and substance use “exclusion provisions,” which had historically allowed private insurers to deny coverage for medical claims related to intoxication. While these provisions were intended to deter risky behavior, they may have also discouraged healthcare providers from screening for substance use. In response, 16 states and the District of Columbia adopted policies prohibiting such denials (PDHIAs). The authors analyze how these reforms have shaped substance use and related social outcomes.

Drawing on multiple national data sources—including crime reports, traffic fatality records, health surveys, and treatment data—the study finds little evidence that PDHIAs increased risky behavior through moral hazard. Instead, the results point to modest improvements, including reductions in certain criminal arrests, declines in drunk driving, and lower alcohol use. One possible explanation is that removing financial penalties encourages providers to more actively identify and refer patients for treatment. Importantly, the study also finds no significant effects on private insurance coverage or premiums, suggesting that these reforms did not disrupt broader insurance markets.

A study by Benjamin Hansen, Kyutaro Matsuzawa, and Joseph J. Sabia examines the relationship between in-person schooling and juvenile violence, shedding light on the potential social cost of traditional education settings. Drawing on four national data sources and multiple identification strategies, the authors use anonymized smartphone data to construct a proxy for in-person school attendance and exploit variation in school calendars—particularly the disruptions during the COVID-19 pandemic. Their findings indicate that in-person schooling is associated with a substantial 28 percent increase in juvenile violent crime. At the same time, no similar effect is observed among young adults, supporting a causal interpretation.

The study suggests that peer interactions play a key role in driving these outcomes. Effects are most pronounced in larger schools and in areas with weaker anti-bullying policies, pointing to the importance of student concentration and peer dynamics. Back-of-the-envelope estimates indicate that, compared to school closures, in-person schooling may generate approximately $233 million in monthly violent crime costs. While the broader benefits of schooling remain well established, the findings highlight the need for policies that address negative peer effects and improve school environments alongside efforts to expand educational access.

Minimum wages are often increased in hopes of improving the well-being of low-wage workers, but their effects on serious public health outcomes remain unclear. In this study, we examine whether raising the minimum wage reduces “deaths of despair” — suicides, drug-related deaths, and alcohol-related deaths. This question matters because these deaths have been linked to long-run economic hardship, especially among less educated adults. Earlier studies reported that higher minimum wages were associated with fewer suicides, but many of those estimates relied on standard two-way fixed effects models that can be misleading when policy effects differ across states or unfold over time. To address this concern, Jooyoung Kim, Daniel Rees, and Joseph J. Sabia use a stacked difference-in-differences approach that is better suited to the timing and variation of state minimum wage changes. 

They combine state-level mortality data from 2000 to 2023 with information on statutory minimum wage increases. This period covers both substantial policy variation and much of the modern opioid epidemic. Across a wide range of difference-in-differences specifications, they find little evidence that raising the minimum wage reduces suicides or drug-related deaths among adults with a high school degree or less. Their estimates are precise enough to rule out sizable protective effects. These findings are robust to alternative empirical approaches, different definitions of large minimum wage increases, alternative time periods, and analyses focused on demographic subgroups. Overall, the results suggest that minimum wage increases alone are unlikely to meaningfully reduce deaths of despair.