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The Effects of the Affordable Care Act on the Near Elderly: Evidence for Health Insurance Coverage and Labor Market Outcomes

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  • Mark Duggan
  • Gopi Shah Goda
  • Gina Li

Abstract

The Affordable Care Act (ACA) not only changed the landscape of health insurance coverage in the United States but also affected the relationship between working decisions and health insurance. In this paper, we estimate the impact of the ACA on the near elderly (ages 60–64) in the 5 years after the implementation of its key provisions in early 2014. We exploit variation across geographic areas in the preexisting level of uninsurance and use 65–69-year-olds, whose insurance coverage was unaffected by the ACA, as a within-region control group. Our findings indicate that the ACA increased health insurance coverage among the near elderly by 4.5 percentage points and reduced their labor force participation rate by 0.6 percentage points.

Suggested Citation

  • Mark Duggan & Gopi Shah Goda & Gina Li, 2021. "The Effects of the Affordable Care Act on the Near Elderly: Evidence for Health Insurance Coverage and Labor Market Outcomes," Tax Policy and the Economy, University of Chicago Press, vol. 35(1), pages 179-223.
  • Handle: RePEc:ucp:tpolec:doi:10.1086/713496
    DOI: 10.1086/713496
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    1. Mark Duggan & Gopi Shah Goda & Emilie Jackson, 2019. "The Effects of the Affordable Care Act on Health Insurance Coverage and Labor Market Outcomes," National Tax Journal, National Tax Association;National Tax Journal, vol. 72(2), pages 261-322, June.
    2. 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.
    3. Erkmen Giray Aslim, 2019. "The Relationship Between Health Insurance and Early Retirement: Evidence from the Affordable Care Act," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 45(1), pages 112-140, January.
    4. Finkelstein, Amy & McKnight, Robin, 2008. "What did Medicare do? The initial impact of Medicare on mortality and out of pocket medical spending," Journal of Public Economics, Elsevier, vol. 92(7), pages 1644-1668, July.
    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. Gustman, Alan L. & Steinmeier, Thomas L. & Tabatabai, Nahid, 2019. "The Affordable Care Act as retiree health insurance: implications for retirement and Social Security claiming," Journal of Pension Economics and Finance, Cambridge University Press, vol. 18(3), pages 415-449, July.
    7. Hamersma, Sarah & Kim, Matthew, 2013. "Participation and crowd out: Assessing the effects of parental Medicaid expansions," Journal of Health Economics, Elsevier, vol. 32(1), pages 160-171.
    8. Kevin Wood, 2019. "Health insurance reform and retirement: Evidence from the Affordable Care Act," Health Economics, John Wiley & Sons, Ltd., vol. 28(12), pages 1462-1475, December.
    9. Kolstad, Jonathan T. & Kowalski, Amanda E., 2012. "The impact of health care reform on hospital and preventive care: Evidence from Massachusetts," Journal of Public Economics, Elsevier, vol. 96(11), pages 909-929.
    10. Frean, Molly & Gruber, Jonathan & Sommers, Benjamin D., 2017. "Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act," Journal of Health Economics, Elsevier, vol. 53(C), pages 72-86.
    11. Padmaja Ayyagari, 2019. "Health Insurance and Early Retirement Plans: Evidence from the Affordable Care Act," American Journal of Health Economics, MIT Press, vol. 5(4), pages 533-560, Fall.
    12. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-1296, December.
    13. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    14. 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.
    15. Amy Finkelstein, 2007. "The Aggregate Effects of Health Insurance: Evidence from the Introduction of Medicare," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 1-37.
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    Citations

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    Cited by:

    1. Isaac, Elliott & Jiang, Haibin, 2022. "Tax-Based Marriage Incentives in the Affordable Care Act," IZA Discussion Papers 15331, Institute of Labor Economics (IZA).
    2. Guo, Hao & Zou, Miaomiao & Liu, Yue, 2023. "Effects of the affordable care act on insurance coverage and labor supply for noncitizen immigrants," Economic Modelling, Elsevier, vol. 119(C).
    3. Aslim, Erkmen Giray, 2022. "Public health insurance and employment transitions," Labour Economics, Elsevier, vol. 75(C).
    4. Luke Petach & David K. Wyant, 2023. "The union advantage: union membership, access to care, and the Affordable Care Act," International Journal of Health Economics and Management, Springer, vol. 23(1), pages 1-26, March.
    5. Reagan A. Baughman, 2022. "The Affordable Care Act and regulation: Coverage effects of guaranteed issue and ratings reform," Health Economics, John Wiley & Sons, Ltd., vol. 31(12), pages 2575-2592, December.
    6. Jeffrey Clemens & Drew McNichols & Joseph J. Sabia, 2020. "The Long-Run Effects of the Affordable Care Act: A Pre-Committed Research Design Over the COVID-19 Recession and Recovery," NBER Working Papers 27999, National Bureau of Economic Research, Inc.
    7. Bottasso, Anna & Cerruti, Gianluca & Conti, Maurizio & Stancanelli, Elena G. F., 2022. "The Effects of the Affordable Care Act on Labour Supply and Other Uses of Time," IZA Discussion Papers 15415, Institute of Labor Economics (IZA).
    8. Sezen O. Onal, 2023. "Does the ACA Medicaid Expansion Encourage Labor Market Exits of Older Workers?," Journal of Labor Research, Springer, vol. 44(1), pages 56-93, June.

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    More about this item

    JEL classification:

    • H31 - Public Economics - - Fiscal Policies and Behavior of Economic Agents - - - Household
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • J21 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Labor Force and Employment, Size, and Structure

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