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The Impact of Health Reform on Job Mobility: Evidence from Massachusetts


  • Bradley T. Heim

    () (School of Public and Environmental Affairs, Indiana University)

  • Ithai Z. Lurie

    (US Department of the Treasury)


This paper estimates the impact of the implementation of the 2006 Massachusetts health reform on job mobility. Theoretically, the effect is ambiguous, as the public health insurance expansion and low-income subsidies would be expected to increase mobility, but the employer mandate and price effects could either increase or decrease mobility depending on the relative impacts on an individual's current job and the attractiveness of other modes of employment or retirement. Utilizing data from tax returns that span 2002–10, in which job changes are identified using employer information reported on W-2 forms, we estimate the impact of the Massachusetts reform using a difference-in-differences approach, comparing the prevalence of job changes in Massachusetts to those of a comparison group, while controlling for individual fixed effects. The estimates suggest the Massachusetts reform generally did not have a significant impact on job separations overall, though it may have increased separations from primary jobs among married women. There is evidence, however, that mobility increased among low-income married couples, young married men, and older married women.

Suggested Citation

  • Bradley T. Heim & Ithai Z. Lurie, 2015. "The Impact of Health Reform on Job Mobility: Evidence from Massachusetts," American Journal of Health Economics, MIT Press, vol. 1(3), pages 374-398, Summer.
  • Handle: RePEc:tpr:amjhec:v:1:y:2015:i:3:p:374-398

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    References listed on IDEAS

    1. Bradley T. Heim & Ithai Z. Lurie & James Pearce, 2014. "Who Pays Taxes? A Dynamic Perspective," National Tax Journal, National Tax Association;National Tax Journal, vol. 67(4), pages 755-778, December.
    2. Craig Garthwaite & Tal Gross & Matthew J. Notowidigdo, 2014. "Public Health Insurance, Labor Supply, and Employment Lock," The Quarterly Journal of Economics, Oxford University Press, vol. 129(2), pages 653-696.
    3. Julie Shi, 2016. "Income Responses to Health Insurance Subsidies: Evidence from Massachusetts," American Journal of Health Economics, MIT Press, vol. 2(1), pages 96-124, Winter.
    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. 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.
    6. Albert A. Okunade & Phanindra V. Wunnava, 2002. "Availability of Health Insurance and Gender Differences in “Job-Lock” Behavior: Evidence from NLSY," Journal of Forensic Economics, National Association of Forensic Economics, vol. 15(2), pages 195-204, April.
    7. Brigitte C. Madrian, 1994. "Employment-Based Health Insurance and Job Mobility: Is there Evidence of Job-Lock?," The Quarterly Journal of Economics, Oxford University Press, vol. 109(1), pages 27-54.
    8. Bradley Heim & Ithai Lurie, 2014. "Does health reform affect self-employment? Evidence from Massachusetts," Small Business Economics, Springer, vol. 43(4), pages 917-930, December.
    9. Anna Sanz-De-Galdeano, 2006. "Job-Lock and Public Policy: Clinton's Second Mandate," ILR Review, Cornell University, ILR School, vol. 59(3), pages 430-437, April.
    10. Robert H. Topel & Michael P. Ward, 1992. "Job Mobility and the Careers of Young Men," The Quarterly Journal of Economics, Oxford University Press, vol. 107(2), pages 439-479.
    11. Borjas, George J., 2003. "Welfare reform, labor supply, and health insurance in the immigrant population," Journal of Health Economics, Elsevier, vol. 22(6), pages 933-958, November.
    12. Cynthia Bansak & Steven Raphael, 2008. "The State Children's Health Insurance Program and Job Mobility: Identifying Job Lock among Working Parents in Near-Poor Households," ILR Review, Cornell University, ILR School, vol. 61(4), pages 564-579, July.
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    15. Jaewhan Kim & Peter Philips, 2010. "Health Insurance and Worker Retention in the Construction Industry," Journal of Labor Research, Springer, vol. 31(1), pages 20-38, March.
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    Cited by:

    1. Jane G. Gravelle & Sean Lowry, 2016. "The Affordable Care Act, Labor Supply, and Social Welfare," National Tax Journal, National Tax Association;National Tax Journal, vol. 69(4), pages 863-882, December.
    2. Laura J. Owen, 2017. "Part-time Employment and Health Insurance Reform: What Can Massachusetts Tell Us about the Affordable Care Act?," Review of Social Sciences, LAR Center Press, vol. 2(3), pages 1-8, March.
    3. Lee, Jun Yeong & Winters, John V., 2020. "State Medicaid Expansion and the Self-Employed," IZA Discussion Papers 12997, Institute of Labor Economics (IZA).

    More about this item


    Massachusetts; health reform; job mobility;

    JEL classification:

    • D0 - Microeconomics - - General
    • J60 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - General


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