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Are Employer Mandates to Offer Health Insurance Effective in Reducing Subsidized Coverage Crowd-Out of Employer-Sponsored Insurance?

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  • Sean Lyons

    (Congressional Budget Office)

Abstract

In 2015, the Affordable Care Act began requiring large employers to offer affordable health insurance coverage to their full-time employees or pay a penalty. Will this mandate significantly affect the take-up of employer health insurance? This paper analyzes the Massachusetts Health Care and Insurance Reform Law of 2006 to gain some insight on the impact of employer mandates on coverage distributions. Results suggest that the large-firm employer mandate to offer health insurance was effective at reducing subsidized insurance crowd-out of employer-sponsored health insurance among workers who were income-eligible for subsidies. Using a triple-differences identification strategy and a synthetic control group approach, this paper finds that roughly half of those newly taking up employer-sponsored insurance in large firms subjected to the mandate would have enrolled in subsidized coverage had their employer been exempted from or subjected to a more lenient employer mandate.

Suggested Citation

  • Sean Lyons, 2017. "Are Employer Mandates to Offer Health Insurance Effective in Reducing Subsidized Coverage Crowd-Out of Employer-Sponsored Insurance?," American Journal of Health Economics, MIT Press, vol. 3(3), pages 370-391, Summer.
    • Handle: RePEc:tpr:amjhec:v:3:y:2017:i:3:p:370-391
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    File URL: http://www.mitpressjournals.org/doi/pdf/10.1162/AJHE_a_00079
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    References listed on IDEAS

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    1. A. Colin Cameron & Jonah B. Gelbach & Douglas L. Miller, 2008. "Bootstrap-Based Improvements for Inference with Clustered Errors," The Review of Economics and Statistics, MIT Press, vol. 90(3), pages 414-427, August.
    2. Jonathan T. Kolstad & Amanda E. Kowalski, 2012. "Mandate-Based Health Reform and the Labor Market:� Evidence from the Massachusetts Reform," Cowles Foundation Discussion Papers 1855, Cowles Foundation for Research in Economics, Yale University.
    3. Charles J. Courtemanche & Daniela Zapata, 2014. "Does Universal Coverage Improve Health? The Massachusetts Experience," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 33(1), pages 36-69, January.
    4. Miller, Sarah, 2012. "The effect of insurance on emergency room visits: An analysis of the 2006 Massachusetts health reform," Journal of Public Economics, Elsevier, vol. 96(11), pages 893-908.
    5. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    6. 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.
    7. 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.
    8. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 391-430.
    9. Gruber, Jonathan & Simon, Kosali, 2008. "Crowd-out 10 years later: Have recent public insurance expansions crowded out private health insurance?," Journal of Health Economics, Elsevier, vol. 27(2), pages 201-217, March.
    10. Marcus Dillender & Carolyn J. Heinrich & Susan N. Houseman, 2015. "The Potential Effects of Federal Health Insurance Reforms on Employment Arrangements and Compensation," Upjohn Working Papers 15-228, W.E. Upjohn Institute for Employment Research.
    11. Charles Brown, 1980. "Equalizing Differences in the Labor Market," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 94(1), pages 113-134.
    12. Abadie, Alberto & Diamond, Alexis & Hainmueller, Jens, 2010. "Synthetic Control Methods for Comparative Case Studies: Estimating the Effect of California’s Tobacco Control Program," Journal of the American Statistical Association, American Statistical Association, vol. 105(490), pages 493-505.
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    Cited by:

    1. Benjamin R. Handel & Jonathan T. Kolstad, 2021. "The Affordable Care Act After a Decade: Industrial Organization of the Insurance Exchanges," NBER Working Papers 29178, National Bureau of Economic Research, Inc.

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    More about this item

    Keywords

    health; health care; health reform; insurance; Massachusetts; labor market;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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