We investigated the impacts of Medicaid expansion on New York county total health spending and specifics of health spending, including health services, public health facilities and public health administration. Little research considered the financial effect of Medicaid expansion on local governments while well reported are its influences on uninsured rates and health services utilization. New York counties have contributed to health in their boundaries by providing or funding public health services, and supporting a part of the non-federal share of Medicaid expenditures and uncompensated care. Medicaid expansion can reduce the size of county expenditures for health by enrolling more previously uninsured population in the program and offering more generous federal funding for the expanded Medicaid. We offer empirical evidence that Medicaid expansion was associated with reduced county health spending.

We develop a theoretical model where child labour results from a household's trade-off between sending a child to school or to work. Education is considered as a risky investment, since the survival of the child is not certain. We explore the effects of public expenditure on education and health on child labour, specifying a transmission mechanism for each kind of spending. On the one hand, we establish that health expenditure reduces child labour all the more as child mortality rate is high. On the other hand, a moderate aversion to risk is a necessary condition for education expenditure to reduce child labour. Our theoretical results are empirically validated on panel data from 66 developing countries between 1985 and 2000.