IDEAS home Printed from https://ideas.repec.org/a/wly/jpamgt/v43y2024i1p157-191.html
   My bibliography  Save this article

Labor mobility and the Affordable Care Act: Heterogeneous impacts of the preexisting conditions provision

Author

Listed:
  • Laura Connolly
  • Matt Hampton
  • Otto Lenhart

Abstract

The Patient Protection and Affordable Care Act (ACA) preexisting conditions provision ensures that insurance companies can no longer deny coverage, charge higher premiums, or exclude coverage due to a preexisting health condition. In this paper, we evaluate the impact of the provision on labor mobility. We use data from the Panel Study of Income Dynamics for years 2009 through 2019 and estimate difference‐in‐differences models to determine whether the provision improved labor mobility for individuals with chronic conditions. While females respond along the extensive margin by being less likely to work, males experience broader labor mobility improvements. Men are more likely to start a new job, become employed in a different industry, and move to a different state in the post‐policy period. Labor mobility improvements are largest among males with household incomes greater than 138% of the federal poverty level, males ages 35 to 49, and males with conditions first diagnosed more than 10 years ago. Last, we show that the policy improved access to health insurance coverage and reduced the likelihood that health impacts the amount or type of work, which ultimately increased labor market flexibility. Our results highlight the heterogenous impacts of the provision on different subgroups of the population.

Suggested Citation

  • Laura Connolly & Matt Hampton & Otto Lenhart, 2024. "Labor mobility and the Affordable Care Act: Heterogeneous impacts of the preexisting conditions provision," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 43(1), pages 157-191, January.
  • Handle: RePEc:wly:jpamgt:v:43:y:2024:i:1:p:157-191
    DOI: 10.1002/pam.22521
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/pam.22521
    Download Restriction: no

    File URL: https://libkey.io/10.1002/pam.22521?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Gregory Colman & Dhaval Dave, 2018. "It'S About Time: Effects Of The Affordable Care Act Dependent Coverage Mandate On Time Use," Contemporary Economic Policy, Western Economic Association International, vol. 36(1), pages 44-58, January.
    2. Bradley Heim & Ithai Lurie & Kosali Simon, 2018. "Did the Affordable Care Act Young Adult Provision Affect Labor Market Outcomes? Analysis Using Tax Data," ILR Review, Cornell University, ILR School, vol. 71(5), pages 1154-1178, October.
    3. Grace Lordan & Jörn‐Steffen Pischke, 2022. "Does Rosie Like Riveting? Male and Female Occupational Choices," Economica, London School of Economics and Political Science, vol. 89(353), pages 110-130, January.
    4. Craig Garthwaite & Tal Gross & Matthew J. Notowidigdo, 2014. "Public Health Insurance, Labor Supply, and Employment Lock," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 129(2), pages 653-696.
    5. James Bailey & Anna Chorniy, 2016. "Employer-Provided Health Insurance And Job Mobility: Did The Affordable Care Act Reduce Job Lock?," Contemporary Economic Policy, Western Economic Association International, vol. 34(1), pages 173-183, January.
    6. David J. G. Slusky & Donna K. Ginther, 2021. "Did Medicaid expansion reduce medical divorce?," Review of Economics of the Household, Springer, vol. 19(4), pages 1139-1174, December.
    7. Alberto Abadie & Guido W. Imbens, 2016. "Matching on the Estimated Propensity Score," Econometrica, Econometric Society, vol. 84, pages 781-807, March.
    8. Joelle Abramowitz, 2016. "Saying, “I Don’t†: The Effect of the Affordable Care Act Young Adult Provision on Marriage," Journal of Human Resources, University of Wisconsin Press, vol. 51(4), pages 933-960.
    9. J Matthew Hampton & Otto Lenhart, 2019. "'Til insurance do us part: the effect of the affordable care act preexisting conditions provision on marriage," Working Papers 1902, University of Strathclyde Business School, Department of Economics.
    10. 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.
    11. Kevin T. Stroupe & Eleanor D. Kinney & Thomas J.J. Kniesner, 2001. "Chronic Illness and Health Insurance-Related Job Lock," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 20(3), pages 525-544.
    12. A. Colin Cameron & Jonah B. Gelbach & Douglas L. Miller, 2008. "Bootstrap-Based Improvements for Inference with Clustered Errors," The Review of Economics and Statistics, MIT Press, vol. 90(3), pages 414-427, August.
    13. William E. Even & David A. Macpherson, 2019. "The Affordable Care Act and the Growth of Involuntary Part-Time Employment," ILR Review, Cornell University, ILR School, vol. 72(4), pages 955-980, August.
    14. Yaa Akosa Antwi & Asako S. Moriya & Kosali Simon, 2013. "Effects of Federal Policy to Insure Young Adults: Evidence from the 2010 Affordable Care Act's Dependent-Coverage Mandate," American Economic Journal: Economic Policy, American Economic Association, vol. 5(4), pages 1-28, November.
    15. 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.
    16. Scott J. Adams, 2004. "Employer‐provided Health Insurance and Job Change," Contemporary Economic Policy, Western Economic Association International, vol. 22(3), pages 357-369, July.
    17. Laura Dague & Thomas DeLeire & Lindsey Leininger, 2017. "The Effect of Public Insurance Coverage for Childless Adults on Labor Supply," American Economic Journal: Economic Policy, American Economic Association, vol. 9(2), pages 124-154, May.
    18. Michel H. Boudreaux & Brandy J. Lipton, 2021. "Medicaid Benefit Generosity and Labor Market Outcomes: Evidence from Medicaid Adult Vision Benefits," Journal of Human Resources, University of Wisconsin Press, vol. 56(2), pages 539-569.
    19. Scott Barkowski, 2020. "Does government health insurance reduce job lock and job push?," Southern Economic Journal, John Wiley & Sons, vol. 87(1), pages 122-169, July.
    20. Robert Kaestner & Bowen Garrett & Jiajia Chen & Anuj Gangopadhyaya & Caitlyn Fleming, 2017. "Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(3), pages 608-642, June.
    21. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    22. James G. MacKinnon & Matthew D. Webb, 2017. "Wild Bootstrap Inference for Wildly Different Cluster Sizes," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 32(2), pages 233-254, March.
    23. Hamersma, Sarah & Kim, Matthew, 2009. "The effect of parental Medicaid expansions on job mobility," Journal of Health Economics, Elsevier, vol. 28(4), pages 761-770, July.
    24. Rachel Croson & Uri Gneezy, 2009. "Gender Differences in Preferences," Journal of Economic Literature, American Economic Association, vol. 47(2), pages 448-474, June.
    25. Charness, Gary & Gneezy, Uri, 2012. "Strong Evidence for Gender Differences in Risk Taking," Journal of Economic Behavior & Organization, Elsevier, vol. 83(1), pages 50-58.
    26. Matthew D. Webb, 2023. "Reworking wild bootstrap‐based inference for clustered errors," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 56(3), pages 839-858, August.
    27. Bernd Fitzenberger & Astrid Kunze, 2005. "Vocational Training and Gender: Wages and Occupational Mobility among Young Workers," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 21(3), pages 392-415, Autumn.
    28. Matt Hampton & Otto Lenhart, 2022. "Access to health care and mental health—Evidence from the ACA preexisting conditions provision," Health Economics, John Wiley & Sons, Ltd., vol. 31(5), pages 760-783, May.
    29. 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.
    30. Brad M. Barber & Terrance Odean, 2001. "Boys will be Boys: Gender, Overconfidence, and Common Stock Investment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 116(1), pages 261-292.
    31. Boyle, Melissa A. & Lahey, Joanna N., 2010. "Health insurance and the labor supply decisions of older workers: Evidence from a U.S. Department of Veterans Affairs expansion," Journal of Public Economics, Elsevier, vol. 94(7-8), pages 467-478, August.
    32. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    33. Depew, Briggs, 2015. "The effect of state dependent mandate laws on the labor supply decisions of young adults," Journal of Health Economics, Elsevier, vol. 39(C), pages 123-134.
    34. Matt Hampton & Otto Lenhart, 2022. "The effect of the Affordable Care Act Medicaid expansion on marriage," Economic Inquiry, Western Economic Association International, vol. 60(2), pages 568-591, April.
    35. Alexandra Bernasek & Stephanie Shwiff, 2001. "Gender, Risk, and Retirement," Journal of Economic Issues, Taylor & Francis Journals, vol. 35(2), pages 345-356, June.
    36. Ofer Malamud & Abigail Wozniak, 2012. "The Impact of College on Migration: Evidence from the Vietnam Generation," Journal of Human Resources, University of Wisconsin Press, vol. 47(4), pages 913-950.
    37. Jonathan Gruber & Brigitte C. Madrian, 1994. "Health Insurance and Job Mobility: The Effects of Public Policy on Job-Lock," ILR Review, Cornell University, ILR School, vol. 48(1), pages 86-102, October.
    38. Matt Hampton & Otto Lenhart, 2019. "The effect of the Affordable Care Act preexisting conditions provision on marriage," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1345-1355, November.
    39. Chatterji, Pinka & Brandon, Peter & Markowitz, Sara, 2016. "Job mobility among parents of children with chronic health conditions: Early effects of the 2010 Affordable Care Act," Journal of Health Economics, Elsevier, vol. 48(C), pages 26-43.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Maclean, Johanna Catherine & Webber, Douglas, 2022. "Government regulation and wages: Evidence from continuing coverage mandates," Labour Economics, Elsevier, vol. 78(C).
    2. Michael S. Kofoed & Wyatt J. Frasier, 2019. "[Job] Locked and [Un]loaded: The Effect of the Affordable Care Act Dependency Mandate on Reenlistment in the U.S. Army," Upjohn Working Papers 19-300, W.E. Upjohn Institute for Employment Research.
    3. 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.
    4. Scott Barkowski, 2020. "Does government health insurance reduce job lock and job push?," Southern Economic Journal, John Wiley & Sons, vol. 87(1), pages 122-169, July.
    5. Tim Bersak, 2019. "Identification of Job Lock and Inefficient Labor Market Mobility," Southern Economic Journal, John Wiley & Sons, vol. 86(2), pages 530-547, October.
    6. 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.
    7. Aparna Soni & Taryn Morrissey, 2022. "The effects of Medicaid expansion on home production and childcare," Southern Economic Journal, John Wiley & Sons, vol. 88(3), pages 931-950, January.
    8. Rajashri Chakrabarti & Maxim Pinkovskiy, 2019. "The Affordable Care Act and the Market for Higher Education," CESifo Working Paper Series 7869, CESifo.
    9. Maclean, J. Catherine & Webber, Douglas A., 2019. "Government Regulation and Lifecycle Wages: Evidence from Continuing Coverage Mandates," IZA Discussion Papers 12464, Institute of Labor Economics (IZA).
    10. 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.
    11. Chatterji, Pinka & Brandon, Peter & Markowitz, Sara, 2016. "Job mobility among parents of children with chronic health conditions: Early effects of the 2010 Affordable Care Act," Journal of Health Economics, Elsevier, vol. 48(C), pages 26-43.
    12. Robert W. Fairlie & Kanika Kapur & Susan Gates, 2016. "Job Lock: Evidence from a Regression Discontinuity Design," Industrial Relations: A Journal of Economy and Society, Wiley Blackwell, vol. 55(1), pages 92-121, January.
    13. Aouad, Marion, 2023. "The intracorrelation of family health insurance and job lock," Journal of Health Economics, Elsevier, vol. 90(C).
    14. 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.
    15. Aslim, Erkmen Giray, 2022. "Public health insurance and employment transitions," Labour Economics, Elsevier, vol. 75(C).
    16. 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).
    17. Bradley Heim & Ithai Lurie & Kosali Simon, 2015. "The Impact of the Affordable Care Act Young Adult Provision on Labor Market Outcomes: Evidence from Tax Data," Tax Policy and the Economy, University of Chicago Press, vol. 29(1), pages 133-157.
    18. Matt Hampton & Otto Lenhart, 2022. "The effect of the Affordable Care Act Medicaid expansion on marriage," Economic Inquiry, Western Economic Association International, vol. 60(2), pages 568-591, April.
    19. Heim, Bradley T. & Hunter, Gillian & Isen, Adam & Lurie, Ithai Z. & Ramnath, Shanthi P., 2021. "Income Responses to the Affordable Care Act: Evidence from a Premium Tax Credit Notch," Journal of Health Economics, Elsevier, vol. 76(C).
    20. Li, Yajuan & Palma, Marco A. & Towne, Samuel, 2017. "Does Health Insurance Provision Improve Self-Employment and Entrepreneurship? Evidence from State Insurance Mandates," 2017 Annual Meeting, July 30-August 1, Chicago, Illinois 258399, Agricultural and Applied Economics Association.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:jpamgt:v:43:y:2024:i:1:p:157-191. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/journal/34787/home .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.