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Health insurance and the supply of entrepreneurs: new evidence from the affordable care act

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  • James Bailey

    (Creighton University)

Abstract

Is the difficulty of purchasing health insurance as an individual or small business a major barrier to entrepreneurship in the USA? I answer this question by taking advantage of the natural experiment provided by the Affordable Care Act’s dependent coverage mandate, which allowed many 19–25 year olds to acquire health insurance independently of their employment. Using a difference-in-difference strategy, I find that the dependent coverage mandate did not increase self-employment among young adults overall, but increased self-employment among disabled young adults by 19–23%.

Suggested Citation

  • James Bailey, 2017. "Health insurance and the supply of entrepreneurs: new evidence from the affordable care act," Small Business Economics, Springer, vol. 49(3), pages 627-646, October.
    • Handle: RePEc:kap:sbusec:v:49:y:2017:i:3:d:10.1007_s11187-017-9856-8
    DOI: 10.1007/s11187-017-9856-8
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    1. King, Gary & Zeng, Langche, 2001. "Logistic Regression in Rare Events Data," Political Analysis, Cambridge University Press, vol. 9(2), pages 137-163, January.
    2. Craig W. Perry & Harvey S. Rosen, 2001. "The Self-Employed Are Less Likely To Have Health Insurance Than Wage Earners: So What?," Working Papers 129, Princeton University, Department of Economics, Center for Economic Policy Studies..
    3. Lex Borghans & Bart H. H. Golsteyn & James J. Heckman & Huub Meijers, 2009. "Gender Differences in Risk Aversion and Ambiguity Aversion," Journal of the European Economic Association, MIT Press, vol. 7(2-3), pages 649-658, 04-05.
    4. Depew, Briggs, 2015. "The effect of state dependent mandate laws on the labor supply decisions of young adults," Journal of Health Economics, Elsevier, vol. 39(C), pages 123-134.
    5. Jonathan Gruber & Brigitte C. Madrian, 2002. "Health Insurance, Labor Supply, and Job Mobility: A Critical Review of the Literature," JCPR Working Papers 255, Northwestern University/University of Chicago Joint Center for Poverty Research.
    6. Gary Solon & Steven J. Haider & Jeffrey M. Wooldridge, 2015. "What Are We Weighting For?," Journal of Human Resources, University of Wisconsin Press, vol. 50(2), pages 301-316.
    7. Holtz-Eakin, Douglas & Penrod, John R. & Rosen, Harvey S., 1996. "Health insurance and the supply of entrepreneurs," Journal of Public Economics, Elsevier, vol. 62(1-2), pages 209-235, October.
    8. Barbaresco, Silvia & Courtemanche, Charles J. & Qi, Yanling, 2015. "Impacts of the Affordable Care Act dependent coverage provision on health-related outcomes of young adults," Journal of Health Economics, Elsevier, vol. 40(C), pages 54-68.
    9. repec:pri:cepsud:71rosen is not listed on IDEAS
    10. Dillender, Marcus, 2014. "Do more health insurance options lead to higher wages? Evidence from states extending dependent coverage," Journal of Health Economics, Elsevier, vol. 36(C), pages 84-97.
    11. Puhani, Patrick A., 2012. "The treatment effect, the cross difference, and the interaction term in nonlinear “difference-in-differences” models," Economics Letters, Elsevier, vol. 115(1), pages 85-87.
    12. Fairlie, Robert W. & Kapur, Kanika & Gates, Susan, 2011. "Is employer-based health insurance a barrier to entrepreneurship?," Journal of Health Economics, Elsevier, vol. 30(1), pages 146-162, January.
    13. Lex Borghans & Bart H.H. Golsteyn & James J. Heckman & Huub Meijers, 2009. "Gender Differences in Risk Aversion and Ambiguity," Working Papers 200903, Geary Institute, University College Dublin.
    14. Depew, Briggs & Bailey, James, 2015. "Did the Affordable Care Act's dependent coverage mandate increase premiums?," Journal of Health Economics, Elsevier, vol. 41(C), pages 1-14.
    15. Yaa Akosa Antwi & Asako S. Moriya & Kosali Simon, 2013. "Effects of Federal Policy to Insure Young Adults: Evidence from the 2010 Affordable Care Act's Dependent-Coverage Mandate," American Economic Journal: Economic Policy, American Economic Association, vol. 5(4), pages 1-28, November.
    16. Alison J. Wellington, 2001. "Health Insurance Coverage And Entrepreneurship," Contemporary Economic Policy, Western Economic Association International, vol. 19(4), pages 465-478, October.
    17. Brigitte C. Madrian, 1994. "Employment-Based Health Insurance and Job Mobility: Is there Evidence of Job-Lock?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 109(1), pages 27-54.
    18. Bradley Heim & Ithai Lurie, 2014. "Does health reform affect self-employment? Evidence from Massachusetts," Small Business Economics, Springer, vol. 43(4), pages 917-930, December.
    19. Jonathan Gruber & James M. Poterba, 1993. "Tax Incentives and the Decision to Purchase Health Insurance: Evidence from the Self-Employed," NBER Working Papers 4435, National Bureau of Economic Research, Inc.
    20. Jonathan Gruber & James Poterba, 1994. "Tax Incentives and the Decision to Purchase Health Insurance: Evidence from the Self-Employed," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 109(3), pages 701-733.
    21. Benjamin R. Handel, 2013. "Adverse Selection and Inertia in Health Insurance Markets: When Nudging Hurts," American Economic Review, American Economic Association, vol. 103(7), pages 2643-2682, December.
    22. Donna B. Gilleskie & Byron F. Lutz, 2002. "The Impact of Employer-Provided Health Insurance on Dynamic Employment Transitions," Journal of Human Resources, University of Wisconsin Press, vol. 37(1), pages 129-162.
    23. Heim, Bradley T. & Lurie, Ithai Z., 2010. "The effect of self-employed health insurance subsidies on self-employment," Journal of Public Economics, Elsevier, vol. 94(11-12), pages 995-1007, December.
    24. Craig William Perry & Harvey S. Rosen, 2001. "The Self-Employed are Less Likely to Have Health Insurance Than Wage Earners. So What?," NBER Working Papers 8316, National Bureau of Economic Research, Inc.
    25. Bradley Heim & Ithai Lurie & Kosali Simon, 2015. "The Impact of the Affordable Care Act Young Adult Provision on Labor Market Outcomes: Evidence from Tax Data," Tax Policy and the Economy, University of Chicago Press, vol. 29(1), pages 133-157.
    26. Craig W. Perry & Harvey S. Rosen, 2001. "The Self-Employed Are Less Likely To Have Health Insurance Than Wage Earners: So What?," Working Papers 129, Princeton University, Department of Economics, Center for Economic Policy Studies..
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    Citations

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    Cited by:

    1. Ghimire Keshar M., 2021. "Supply of immigrant entrepreneurs and native entrepreneurship," IZA Journal of Development and Migration, Sciendo & Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 12(1), pages 1-42, January.
    2. Boris Nikolaev & Christopher John Boudreaux & Matthew Wood, 2020. "Entrepreneurship and Subjective Well-Being: The Mediating Role of Psychological Functioning," Entrepreneurship Theory and Practice, , vol. 44(3), pages 557-586, May.
    3. Fone, Zachary S. & Friedson, Andrew I. & Lipton, Brandy & Sabia, Joseph J., 2020. "The Dependent Coverage Mandate Took a Bite Out of Crime," IZA Discussion Papers 12968, Institute of Labor Economics (IZA).
    4. Barış K. Yörük & Linna Xu, 2019. "Impact of the ACA’s Dependent Coverage Mandate on Health Insurance and Labor Market Outcomes Among Young Adults: Evidence from Regression Discontinuity Design," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 45(1), pages 58-86, January.
    5. Michael S. Kofoed & Wyatt J. Frasier, 2019. "[Job] Locked and [Un]loaded: The Effect of the Affordable Care Act Dependency Mandate on Reenlistment in the U.S. Army," Upjohn Working Papers 19-300, W.E. Upjohn Institute for Employment Research.
    6. Jun Yeong Lee & John V. Winters, 2022. "State Medicaid Expansion and the Self-Employed," Small Business Economics, Springer, vol. 59(3), pages 925-954, October.
    7. Hossain, Md. Mobarak, 2021. "Relationship Between Health Insurance and Self-employment: A Systematic Review," MPRA Paper 105634, University Library of Munich, Germany.
    8. Manuel Hermosilla & Fernanda Gutiérrez-Navratil & Juan Prieto-Rodríguez, 2018. "Can Emerging Markets Tilt Global Product Design? Impacts of Chinese Colorism on Hollywood Castings," Marketing Science, INFORMS, vol. 37(3), pages 356-381, May.
    9. Kwapisz, Agnieszka, 2020. "Health insurance coverage and sources of advice in entrepreneurship: Gender differences," Journal of Business Venturing Insights, Elsevier, vol. 14(C).
    10. Tim Bersak, 2019. "Identification of Job Lock and Inefficient Labor Market Mobility," Southern Economic Journal, John Wiley & Sons, vol. 86(2), pages 530-547, October.
    11. Alyson Ma & Alison Sanchez & Mindy Ma, 2022. "Racial disparities in health care utilization, the affordable care act and racial concordance preference," International Journal of Health Economics and Management, Springer, vol. 22(1), pages 91-110, March.
    12. Nathan Blascak & Vyacheslav Mikhed, 2023. "Health Insurance and Young Adult Financial Distress," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(2), pages 393-423, March.
    13. Karolis Matikonis & Matthew Gobey, 2024. "Small Business Property Tax Reductions and Firm Productivity," Small Business Economics, Springer, vol. 62(1), pages 307-324, January.
    14. Fossen, Frank M. & Hossain, Mobarak & Mukhopadhyay, Sankar & Toth, Peter, 2021. "The Cost of Health Insurance and Entry into Entrepreneurship," IZA Discussion Papers 14891, Institute of Labor Economics (IZA).
    15. James Bailey & Dhaval Dave, 2019. "The Effect of the Affordable Care Act on Entrepreneurship among Older Adults," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 45(1), pages 141-159, January.
    16. Joanna Woronkowicz & Aparna Soni & Seth Freedman & Kosali Simon, 2020. "How have recent health insurance expansions affected coverage among artist occupations in the USA?," Journal of Cultural Economics, Springer;The Association for Cultural Economics International, vol. 44(1), pages 117-154, March.
    17. Lingyu Gao & Xiaoli Wang, 2019. "Healthcare Supply Chain Network Coordination Through Medical Insurance Strategies with Reference Price Effect," IJERPH, MDPI, vol. 16(18), pages 1-23, September.
    18. James Bailey & Gregory Colman & Dhaval Dave, 2022. "The Evolution of Job Lock in the U.S.: Evidence from the Affordable Care Act," JRFM, MDPI, vol. 15(7), pages 1-13, July.
    19. Margaret E. Blume-Kohout, 2024. "Entrepreneurship Lock and the Demand for Health Insurance: Evidence from the US Affordable Care Act," ILR Review, Cornell University, ILR School, vol. 77(2), pages 199-226, March.
    20. Bergmans, Rachel S. & Berger, Lawrence M. & Palta, Mari & Robert, Stephanie A. & Ehrenthal, Deborah B. & Malecki, Kristen, 2018. "Participation in the Supplemental Nutrition Assistance Program and maternal depressive symptoms: Moderation by program perception," Social Science & Medicine, Elsevier, vol. 197(C), pages 1-8.

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    More about this item

    Keywords

    Health insurance; Self-employment; Entrepreneurship lock; Affordable Care Act; Dependent coverage mandate;
    All these keywords.

    JEL classification:

    • L26 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Entrepreneurship
    • J20 - Labor and Demographic Economics - - Demand and Supply of Labor - - - General
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • M13 - Business Administration and Business Economics; Marketing; Accounting; Personnel Economics - - Business Administration - - - New Firms; Startups

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