Chris Hollrah


I am an Economist at the Federal Trade Commission. 

My research interests are public finance and health economics. My current research focuses on cost-sharing for prescriptions drugs and low-income programs.

CV 

Email: chollrah@umich.edu


Research

Prioritizing Value? How Low-Income Patients Respond to Prescription Cost-Sharing (Job Market Paper) [Working Paper]

Cost-sharing is widely used to encourage patients to prioritize cost-effective health care. This paper measures the effects of cost-sharing among older low-income patients, exploiting a discontinuity in eligibility for a prescription drug subsidy for those who lose access to the Medicaid-linked program. Higher drug prices resulting from patients losing the subsidy lead to a 38% average reduction in total prescription expenditures, driven by a 15% reduction in the quantity of prescriptions filled. Patients economize on purchases of higher-priced drugs, irrespective of their health benefits. For example, patients reduce insulin purchases by 26%. There is no evidence that cost-sharing prompts switching from branded drugs to equally effective generics. This behavior suggests that prescription drug cost-sharing reduces prescription accessibility without enhancing cost-effectiveness.

The Long-Term Effects of Income for At-Risk Infants: Evidence from Supplemental Security Income [Working Paper]

With Amelia Hawkins, Sarah Miller, Laura Wherry, Gloria Aldana and Mitchell Wong

Conditionally Accepted, American Economic Review

This paper examines whether a generous cash intervention early in life can "undo'' some of the long-term disadvantage associated with poor health at birth. We use new linkages between several large-scale administrative datasets to examine the short-, medium-, and long-term effects of providing low-income families with low birthweight infants support through the Supplemental Security Income (SSI) program. This program uses a birthweight cutoff at 1200 grams to determine eligibility. We find that families of infants born just below this cutoff experience a large increase in cash benefits totaling about 27% of family income in the first three years of the infant's life. These cash benefits persist at lower amounts through age 10. Eligible infants also experience a small but statistically significant increase in Medicaid enrollment during  childhood. 

We examine whether this support affects health care use and mortality in infancy, educational performance in high school, post-secondary school attendance and college degree attainment, and earnings, public assistance use, and mortality in young adulthood for all infants born in California to low-income families whose birthweight puts them near the cutoff. We also examine whether these payments had spillover effects onto the older siblings of these infants who may have also benefited from the increase in family resources. Despite the comprehensive nature of this early life intervention, we detect no improvements in any of the study outcomes, nor do we find improvements among the older siblings of these infants. These null effects persist across several subgroups and alternative model specifications.  


The Effects of Higher Physician Access Costs on Prescription Utilization [Extended Abstract]

This paper evaluates the extent to which higher costs of visiting a medical provider can impede older low-income patients access to prescription drugs. For Medicare-Medicaid patients that lose Medicaid, differences in administration timing between Medicaid and the Low-Income Subsidy program for prescription drugs generate a several month period where the cost of visiting a provider sharply increases, but prescriptions remain near costless to fill. Patients respond to an average increase of $18 per physician visit (20% of the average total cost of an office visit) by reducing their number of visits by 10%. The reduction in office visits leads to a 5% reduction in quantity of prescriptions filled. The reduction in office visits leads to a 5% reduction in both prescription expenditures and quantity of prescriptions filled on average. This suggests even relatively small increases in the cost of visiting a physician have a meaningful effect on access to prescriptions. 

The Power of Narrative Sentiment in Economic Forecasts  [Paper]

With Steven Sharpe and Nitish Sinha

International Journal of Forecasting


The sentiment, or “Tonality”, extracted from the narratives that accompany Federal Reserve Board (Greenbook) economic forecasts is strongly correlated with future economic performance, positively with GDP and negatively with unemployment and inflation. More notably, Tonality conveys substantial incremental information, as it predicts errors in both Federal Reserve and private-sector point forecasts of unemployment and GDP growth up to four quarters out, with more favorable sentiment predicting better than expected economic performance.  Tonality also has power for positively predicting both monetary policy surprises and stock returns up to four quarters ahead. Quantile regressions indicate that much of Tonality’s forecasting power arises from its signal of downside risks to economic performance and stock returns. Moreover, if observed in real time, tonality would have been particularly informative about prospective economic performance and stock returns at times when economic uncertainty was high or when point forecasts called for subpar GDP growth.


Teaching


TA for Introduction to Research I (PhD)

Fall 2023


TA for Econometric I (Undergraduate)

 Fall 2021


TA for Calculus I and II (Undergraduate)

Fall 2014, Spring 2015, Fall 2015, Spring 2016