Cradle to grave: Three essays on the impact of tax and public policies in the United States

Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




Thomas J. Kniesner


Essays, Public policies, Tax reform

Subject Categories

Economics | Labor Economics | Public Affairs, Public Policy and Public Administration | Public Policy | Social and Behavioral Sciences


My first essay is a study of tax policy and US marital fertility. Marginal tax rate changes have the ability to affect fertility decisions by altering the opportunity cost of time through a change in the after-tax wage. Using a natural experiments framework developed to examine women's labor force participation I investigate the effect of the Tax Reform Act of 1986 on marital fertility. The data were from the March Current Population Survey. I find the women who faced the largest drop in their marginal tax rate increased their fertility by 15 percent after TRA86 relative to a control group who faced a smaller cut.

The second essay examines the change in the mix of income and benefits that older adults receive as the age, with a focus on older women. My study is a cross-national comparison of five OECD countries and the data come from the Luxemburg Income Study. To investigate how private income and social benefits change over time, I create synthetic cohorts and follow them for twenty years on average, depending on the availability of data. What my study reveals is that older women rely heavily on socially provided benefits for a majority of their income, and these benefits are primarily responsible for whether older women find themselves in poverty or not. As a result of my study, I recommend that a policy targeting the very poorest older adults could achieve significant reductions in poverty.

In the third essay I examine the use of home health agency services and allied health services after the implementation of changes to the payment scheme mandated by the Balanced Budget Act of 1997. I compare the home health service use of two groups of older adults: Medicare-only eligible population and a dually-eligible population, defined as being eligible for both Medicare and Medicaid. The results of my research suggest a small (approximately 2 percent) and statistically insignificant difference in home health care visits between the dually-eligible population and the Medicare-only population. However, the results show that dually-eligible people had far more outpatient department visits post-BBA1997 (approximately 45 percent more) and more office-based visits with a physician.


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