Many public programs let individuals choose between publicly provided benefits and a subsidized private alternative. We investigate health insurance choice in Medicare—a setting with vast geographic variation in the uptake of the private alternative. We analyze insurance decisions among individuals who move to quantify the relative importance of individual-specific factors (e.g., preferences or income) and place-specific factors (e.g., local health insurance options). We find roughly 40% of the geographic variation in the share selecting private coverage is due to place-based factors, while the remainder due to individuals. Our findings inform the potential for place-based policy to address geographic disparities.

Countercyclical variation in individuals' idiosyncratic labor income risk could generate substantial welfare costs. Following past research, we infer income volatility—the variance of permanent income shocks, a standard proxy for income risk—from the rate at which cross-sectional variances of income rise over the life cycle for a given cohort. Our novelty lies in exploiting cross-state variation in state economic conditions or state sensitivity to national economic conditions. We find that income volatility is higher in good state times than bad; during good national times, we find volatility is higher in states that are more sensitive to national conditions.