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The impact of the Affordable Care Act on self‐employment

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  • Bradley T. Heim
  • Lang Kate Yang

Abstract

This paper estimates the impact of the implementation of the Affordable Care Act (ACA) in 2014 on the decision to be self‐employed. Using data from the Current Population Survey, we employ two identification strategies. Utilizing prereform variation in state nongroup health insurance market regulations, we find that the ACA did not increase self‐employment overall in states that lacked similar provisions in their nongroup markets prior to 2014. In specifications that utilize variation across individuals in characteristics that could make it harder for them to purchase insurance if they left their current employer, we also do not find that the ACA differentially increased self‐employment. However, in states that lacked the ACA nongroup market provisions, we do find a statistically significant increase in the second year of implementation (when individuals had more time to adjust behavior and the exchanges functioned properly) among individuals eligible for insurance subsidies, suggesting that a combination of time to adjust, low uncertainty and low insurance costs may be necessary for nongroup health insurance reforms to impact self‐employment.

Suggested Citation

  • Bradley T. Heim & Lang Kate Yang, 2017. "The impact of the Affordable Care Act on self‐employment," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 256-273, December.
    • Handle: RePEc:wly:hlthec:v:26:y:2017:i:12:p:e256-e273
    DOI: 10.1002/hec.3500
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    References listed on IDEAS

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    1. 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.
    2. James Benjamin Bailey, 2013. "Health Insurance and the Supply of Entrepreneurs: New Evidence from the Affordable Care Act's Dependent Coverage Mandate," 2013 Papers pba1129, Job Market Papers.
    3. Brigitte Madrian, "undated". "The Effect of Health Insurance on Transitions to Self Employment," University of Chicago - Population Research Center 98-5, Chicago - Population Research Center.
    4. 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.
    5. Lo Sasso, Anthony T. & Lurie, Ithai Z., 2009. "Community rating and the market for private non-group health insurance," Journal of Public Economics, Elsevier, vol. 93(1-2), pages 264-279, February.
    6. Alison J. Wellington, 2001. "Health Insurance Coverage And Entrepreneurship," Contemporary Economic Policy, Western Economic Association International, vol. 19(4), pages 465-478, October.
    7. Bradley T. Heim & Ithai Z. Lurie, 2014. "DID REFORM OF THE NON‐GROUP HEALTH INSURANCE MARKET AFFECT THE DECISION TO BE SELF‐EMPLOYED? EVIDENCE FROM STATE REFORMS IN THE 1990s," Health Economics, John Wiley & Sons, Ltd., vol. 23(7), pages 841-860, July.
    8. Rachel Croson & Uri Gneezy, 2009. "Gender Differences in Preferences," Journal of Economic Literature, American Economic Association, vol. 47(2), pages 448-474, June.
    9. Gumus, Gulcin & Regan, Tracy L., 2015. "Self-employment and the role of health insurance in the U.S," Journal of Business Venturing, Elsevier, vol. 30(3), pages 357-374.
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    Cited by:

    1. 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.
    2. Lim, Katherine & Michelmore, Katherine, 2018. "The EITC and self-employment among married mothers," Labour Economics, Elsevier, vol. 55(C), pages 98-115.
    3. Kwapisz, Agnieszka, 2020. "Health insurance coverage and sources of advice in entrepreneurship: Gender differences," Journal of Business Venturing Insights, Elsevier, vol. 14(C).
    4. Juhana Peltonen & Edvard Johansson & Joakim Wincent, 2020. "Does attention‐deficit hyperactivity disorder medication reduce entrepreneurship?," Health Economics, John Wiley & Sons, Ltd., vol. 29(9), pages 1071-1077, September.
    5. 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.
    6. 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.

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