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

Author

Listed:
  • 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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    Cited by:

    1. Aslim, Erkmen Giray, 2022. "Public health insurance and employment transitions," Labour Economics, Elsevier, vol. 75(C).
    2. 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.
    3. 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.
    4. Elliott Isaac & Haibin Jiang, 2025. "Tax-Based Marriage Incentives in the Affordable Care Act," National Tax Journal, University of Chicago Press, vol. 78(2), pages 369-413.
    5. 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).
    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. Anna Bottasso & Gianluca Cerruti & Maurizio Conti & Elena Stancanelli, 2026. "The effects of the affordable care act on labor supply and other uses of time," Economia Politica: Journal of Analytical and Institutional Economics, Springer;Fondazione Edison, vol. 43(1), pages 361-384, April.
    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.

    More about this item

    JEL classification:

    • H2 - Public Economics - - Taxation, Subsidies, and Revenue
    • H31 - Public Economics - - Fiscal Policies and Behavior of Economic Agents - - - Household
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination
    • J21 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Labor Force and Employment, Size, and Structure
    • J26 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Retirement; Retirement Policies

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