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Does health care reform support self-employment?

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  • Thealexa Becker
  • Didem Tuzemen

Abstract

Health insurance access can influence individuals' labor market decisions. Some economists argue employer-provided health insurance may have deterred entrepreneurship, as self-employed individuals may have faced difficulties in obtaining coverage. As the Patient Protection and Affordable Care Act (PPACA) is gradually implemented, the reform might affect individuals' decisions to become or remain self-employed. Tzemen and Becker examine a similar reform, the Massachusetts Health Care Reform Act, as a case study for the PPACA. They find the uninsured rate declined in Massachusetts following the reform for working-age individuals in general and for the self-employed in particular. Additionally, the self-employment share stayed flat in the state while declining in the rest of the nation. The authors conclude the reform may have supported self-employment in Massachusetts, and suggest the PPACA might have similar effects on the national self-employment share.

Suggested Citation

  • Thealexa Becker & Didem Tuzemen, 2014. "Does health care reform support self-employment?," Economic Review, Federal Reserve Bank of Kansas City, issue Q III, pages 5-23.
    • Handle: RePEc:fip:fedker:00017
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    References listed on IDEAS

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    1. Gruber, Jonathan & Madrian, Brigitte C., 1997. "Employment separation and health insurance coverage," Journal of Public Economics, Elsevier, vol. 66(3), pages 349-382, December.
    2. 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.
    3. Kolstad, Jonathan T. & Kowalski, Amanda E., 2016. "Mandate-based health reform and the labor market: Evidence from the Massachusetts reform," Journal of Health Economics, Elsevier, vol. 47(C), pages 81-106.
    4. 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.
    5. Currie, Janet & Madrian, Brigitte C., 1999. "Health, health insurance and the labor market," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 50, pages 3309-3416, Elsevier.
    6. 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.
    7. 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.
    8. Sharon K. Long & Karen Stockley & Alshadye Yemane, 2009. "Another Look at the Impacts of Health Reform in Massachusetts: Evidence Using New Data and a Stronger Model," American Economic Review, American Economic Association, vol. 99(2), pages 508-511, May.
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    Cited by:

    1. Li, Yajuan & Palma, Marco A. & Towne, Samuel, 2017. "Does Health Insurance Provision Improve Self-Employment and Entrepreneurship? Evidence from State Insurance Mandates," 2017 Annual Meeting, July 30-August 1, Chicago, Illinois 258399, Agricultural and Applied Economics Association.

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