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Public Health Insurance, Labor Supply, and Employment Lock

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  • Craig Garthwaite
  • Tal Gross
  • Matthew J. Notowidigdo

Abstract

We study the effect of public health insurance eligibility on labor supply by exploiting the largest public health insurance disenrollment in the history of the United States. In 2005, approximately 170,000 Tennessee residents abruptly lost public health insurance coverage. Using both across- and within-state variation in exposure to the disenrollment, we estimate large increases in labor supply, primarily along the extensive margin. The increased employment is concentrated among individuals working at least 20 hours per week and receiving private, employer-provided health insurance. We explore the dynamic effects of the disenrollment and find an immediate increase in job search behavior and a steady rise in both employment and health insurance coverage following the disenrollment. Our results suggest a significant degree of “employment lock” – workers employed primarily in order to secure private health insurance coverage. The results also suggest that the Affordable Care Act – which similarly affects adults not traditionally eligible for public health insurance – may cause large reductions in the labor supply of low-income adults.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 19220.

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Date of creation: Jul 2013
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Handle: RePEc:nbr:nberwo:19220

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References

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  1. Joseph J. Doyle, 2005. "Health Insurance, Treatment and Outcomes: Using Auto Accidents as Health Shocks," The Review of Economics and Statistics, MIT Press, vol. 87(2), pages 256-270, May.
  2. Martin B. Hackmann & Jonathan T. Kolstad & Amanda E. Kowalski, 2013. "Adverse Selection and an Individual Mandate: When Theory Meets Practice," Cowles Foundation Discussion Papers 1899, Cowles Foundation for Research in Economics, Yale University.
  3. Madrian, Brigitte C, 1994. "Employment-Based Health Insurance and Job Mobility: Is There Evidence of Job-Lock?," The Quarterly Journal of Economics, MIT Press, vol. 109(1), pages 27-54, February.
  4. 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.
  5. 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.
  6. Martin B. Hackmann & Jonathan T. Kolstad & Amanda E. Kowalski, 2012. "Health Reform, Health Insurance, and Selection: Estimating Selection into Health Insurance Using the Massachusetts Health Reform," NBER Working Papers 17748, National Bureau of Economic Research, Inc.
  7. 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, 01.
  8. Baily, Martin Neil, 1978. "Some aspects of optimal unemployment insurance," Journal of Public Economics, Elsevier, vol. 10(3), pages 379-402, December.
  9. Anthony T. LoSasso & Thomas C. Buchmueller, 2002. "The Effect of the State Children's Health Insurance Program on Health Insurance Coverage," NBER Working Papers 9405, National Bureau of Economic Research, Inc.
  10. Aaron Yelowitz, 1995. "The Medicaid Notch, Labor Supply and Welfare Participation: Evidence from Eligibility Expansions," UCLA Economics Working Papers 738, UCLA Department of Economics.
  11. Gruber, Jonathan, 1994. "The Incidence of Mandated Maternity Benefits," American Economic Review, American Economic Association, vol. 84(3), pages 622-41, June.
  12. Congressional Budget Office, 2010. "The Budget and Economic Outlook: An Update," Reports 21670, Congressional Budget Office.
  13. David Card & Lara D. Shore-Sheppard, 2002. "Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low Income Children," NBER Working Papers 9058, National Bureau of Economic Research, Inc.
  14. Chetty, Nadarajan & Weber, Andrea & Guren, Adam Michael & Day, Manoli, 2011. "Are Micro and Macro Labor Supply Elasticities Consistent? A Review of Evidence on the Intensive and Extensive Margins," Scholarly Articles 11878970, Harvard University Department of Economics.
  15. Phillip B. Levine & Robin McKnight & Samantha Heep, 2011. "How Effective Are Public Policies to Increase Health Insurance Coverage among Young Adults?," American Economic Journal: Economic Policy, American Economic Association, vol. 3(1), pages 129-56, February.
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Cited by:
  1. Laura Dague & Thomas DeLeire & Lindsey Leininger, 2014. "The Effect of Public Insurance Coverage for Childless Adults on Labor Supply," NBER Working Papers 20111, National Bureau of Economic Research, Inc.
  2. Marianne P. Bitler & Madeline Zavodny, 2014. "Medicaid: A Review of the Literature," NBER Working Papers 20169, National Bureau of Economic Research, Inc.
  3. Pashchenko, Svetlana & Porapakkarm, Ponpoje, 2013. "Work Incentives of Medicaid Beneficiaries and The Role of Asset Testing," MPRA Paper 49730, University Library of Munich, Germany.
  4. Molloy, Raven & Smith, Christopher L. & Wozniak, Abigail, 2014. "Declining Migration within the US: The Role of the Labor Market," IZA Discussion Papers 8149, Institute for the Study of Labor (IZA).
  5. Raven Molloy & Christopher L. Smith & Abigail Wozniak, 2013. "Declining migration within the US: the role of the labor market," Finance and Economics Discussion Series 2013-27, Board of Governors of the Federal Reserve System (U.S.).
  6. Dague, Laura & DeLeire, Thomas C. & Leininger, Lindsey, 2014. "The Effect of Public Insurance Coverage for Childless Adults on Labor Supply," IZA Discussion Papers 8187, Institute for the Study of Labor (IZA).

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