I study how government policies affect economic opportunity and access to
public services in historically marginalized communities, with a focus on
Puerto Rico. My research statement describes these papers and my next
projects on public safety, tax incentives, and physician supply.
Public health systems increasingly buy care from private providers:
the U.S. Veterans Health Administration more than doubled such
spending in 2014–2021 (Congressional Budget Office, 2021), New
Zealand’s private share of publicly funded elective procedures nearly
doubled from 2011–12 to 2023–24 (Radio New Zealand, 2026), and
England’s health department bought £24.1 billion of care outside the
NHS in 2024–25 (National Audit Office, 2026). Yet little is known about
how patients fare when a publicly financed health system moves
entirely from public provision to private management. To study this
shift at full scale, we examine Puerto Rico’s 1994–2000 health reform,
which changed facility ownership, provider payment incentives,
eligibility, and access. Exploiting the reform’s staggered rollout
across counties, we find that it raised all-cause mortality by 3.7
percent. The increase is accompanied by lower ambulatory-care
employment, fewer hospitals, and lower use of early prenatal care,
consistent with reduced provider capacity and access to timely care as
possible mechanisms. These findings suggest that a broad shift toward
privately managed care may harm patient health.
Working papers
Corporate Tax Incentives Retraction: Evidence from Puerto Rico
We know much about the effects of introducing place-based tax
incentives for corporations. Given how costly these incentives are, we
know surprisingly little about their effects once they are retracted.
To fill this gap, this paper studies the retraction of one of the
costliest corporate tax incentives in the United States, Section 936 of
the U.S. Internal Revenue Code. This incentive exempted U.S.
corporations from federal tax on income earned in Puerto Rico from 1976
until Congress phased it out beginning in 1996 and eliminated it in
2006. Manufacturing claimed 98 percent of the tax credits and produced a
median 45.5 percent of island GDP at the time, making it one of the most
important industries in the economy. Using synthetic
difference-in-differences on employment data for Puerto Rico and U.S.
states, this paper estimates that manufacturing employment fell 9.2
percent by 2000, 13.3 percent by the close of the phase-out in 2005, and
28.0 percent by 2019, relative to the counterfactual. Results show no
return to baseline employment levels two decades later. The average
county-level decline is 13.6 percent, and reaches 18.2 percent in
high-poverty counties. This evidence leads us to conclude that even
after three decades of tax subsidy, the retraction of place-based tax
incentives fails to ignite self-sustaining industries.
Work in progress
Physician Migration from Puerto Rico and the Health of Receiving Communities
with Jori Barash (University of Oregon)
Does adding physicians improve health where they arrive? Physicians
choose where to practice, so comparisons across communities can
confound the effects of physician supply with differences in local
demand. We study the physicians who left Puerto Rico after Hurricane
Maria in September 2017 and propose each mainland county’s 2010 share
of residents born in Puerto Rico as an instrument for where they
settled. Outcomes include hospital use, preventable hospitalizations,
access to care, and mortality from 2012 to 2022. We also ask whether
effects are larger for Hispanic patients, as an indicator of homophily.