Nicole Maestas
Nicole Maestas, PhD, is an associate professor of health care policy at Harvard Medical School. Her research studies how the health and disability insurance systems affect individual economic behaviors, such as labor supply and the consumption of medical care.
Dr. Maestas’ research in disability economics has shown how the federal disability insurance system discourages employment by people with disabilities. Applying a causal research design to newly developed administrative data, her work showed that the work capacity of disability insurance beneficiaries with less severe disabilities is substantial. Furthermore, individuals lose additional work capacity the longer they stay out of the labor force pursuing a disability determination.
Dr. Maestas’ work on the effects of health insurance coverage showed that the onset of Medicare eligibility causes a sharp increase in the use of health care services. For low-cost services, such as routine doctor visits, Medicare eligibility leads to increases in utilization that are concentrated among groups with the lowest rates of insurance coverage prior to age 65. But for relatively high-cost procedures—including hospitalization for procedures like bypass surgery and hip and knee replacement—the gains are concentrated among groups with the highest rates of insurance coverage prior to age 65 (and who are also more likely to have supplementary insurance coverage after 65). As a result, Medicare narrows disparities in access to care, but appears to widen disparities in elective care. Closely related work presented the first causal evidence of an insurance-induced mortality gap: Medicare coverage causes a nearly 1-percentage-point drop in 7-day mortality for patients at age 65, equivalent to a 20% reduction in deaths for this severely ill patient group.
Her work on the economics of aging has demonstrated significant shifts in labor supply patterns at older ages. She showed that one-half of all retirees pursue a retirement transition path that involves partial retirement or labor force re-entry (“unretirement”) and that re-entry was largely predictable ex ante, and not a consequence of economic shocks. She has also argued that labor supply at older ages is likely to increase still further, even absent policy changes to promote employment at older ages, due to increased labor demand for older workers. Indeed, her work shows that the rise in employment at older ages was driven in substantial part by an increase in labor demand by firms in the professional services industries. In current work, she is examining how these labor force trends, and population aging more generally, affect economic growth.
Dr. Maestas has testified before Congress about her research on two occasions, once before the U.S. House Ways and Means Committee and once before the Senate Finance Committee. She recently completed service on a national disability policy panel convened by the Social Security Advisory Board.
Dr. Maestas graduated Phi Beta Kappa from Wellesley College. She received her MPP in public policy from the Goldman School of Public Policy at UC Berkeley, and her PhD in economics also from UC Berkeley. Prior to joining Harvard, Dr. Maestas was a senior economist at RAND, where she served as director of the Economics, Sociology and Statistics Research Department, director of the Center for Disability Research, director of the NIA (T32) Postdoctoral Training Program in the Study of Aging, and director of the NIA-sponsored RAND Summer Institute’s Mini-Medical School for Social Scientists.
Dr. Maestas’ research in disability economics has shown how the federal disability insurance system discourages employment by people with disabilities. Applying a causal research design to newly developed administrative data, her work showed that the work capacity of disability insurance beneficiaries with less severe disabilities is substantial. Furthermore, individuals lose additional work capacity the longer they stay out of the labor force pursuing a disability determination.
Dr. Maestas’ work on the effects of health insurance coverage showed that the onset of Medicare eligibility causes a sharp increase in the use of health care services. For low-cost services, such as routine doctor visits, Medicare eligibility leads to increases in utilization that are concentrated among groups with the lowest rates of insurance coverage prior to age 65. But for relatively high-cost procedures—including hospitalization for procedures like bypass surgery and hip and knee replacement—the gains are concentrated among groups with the highest rates of insurance coverage prior to age 65 (and who are also more likely to have supplementary insurance coverage after 65). As a result, Medicare narrows disparities in access to care, but appears to widen disparities in elective care. Closely related work presented the first causal evidence of an insurance-induced mortality gap: Medicare coverage causes a nearly 1-percentage-point drop in 7-day mortality for patients at age 65, equivalent to a 20% reduction in deaths for this severely ill patient group.
Her work on the economics of aging has demonstrated significant shifts in labor supply patterns at older ages. She showed that one-half of all retirees pursue a retirement transition path that involves partial retirement or labor force re-entry (“unretirement”) and that re-entry was largely predictable ex ante, and not a consequence of economic shocks. She has also argued that labor supply at older ages is likely to increase still further, even absent policy changes to promote employment at older ages, due to increased labor demand for older workers. Indeed, her work shows that the rise in employment at older ages was driven in substantial part by an increase in labor demand by firms in the professional services industries. In current work, she is examining how these labor force trends, and population aging more generally, affect economic growth.
Dr. Maestas has testified before Congress about her research on two occasions, once before the U.S. House Ways and Means Committee and once before the Senate Finance Committee. She recently completed service on a national disability policy panel convened by the Social Security Advisory Board.
Dr. Maestas graduated Phi Beta Kappa from Wellesley College. She received her MPP in public policy from the Goldman School of Public Policy at UC Berkeley, and her PhD in economics also from UC Berkeley. Prior to joining Harvard, Dr. Maestas was a senior economist at RAND, where she served as director of the Economics, Sociology and Statistics Research Department, director of the Center for Disability Research, director of the NIA (T32) Postdoctoral Training Program in the Study of Aging, and director of the NIA-sponsored RAND Summer Institute’s Mini-Medical School for Social Scientists.