IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/19220.html
   My bibliography  Save this paper

Public Health Insurance, Labor Supply, and Employment Lock

Author

Listed:
  • 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.

Suggested Citation

  • Craig Garthwaite & Tal Gross & Matthew J. Notowidigdo, 2013. "Public Health Insurance, Labor Supply, and Employment Lock," NBER Working Papers 19220, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:19220
    Note: HC LS PE
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w19220.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Congressional Budget Office, 2010. "The Budget and Economic Outlook: An Update," Reports 21670, Congressional Budget Office.
    2. Nathaniel Hendren, 2013. "Private Information and Insurance Rejections," Econometrica, Econometric Society, vol. 81(5), pages 1713-1762, September.
    3. Judith Wooldridge & Leighton Ku & Teresa Coughlin & Lisa Dubay & Marilyn Ellwood & Shruti Rajan & Sheila Hoag, 1996. "Implementing State Health Care Reform: What Have We Learned from the First Year? The First Annual Report of the Evaluation of Health Reform in Five States," Mathematica Policy Research Reports a47179c19b0e4b3ea2a65cfc3, Mathematica Policy Research.
    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. 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, January.
    6. Martin B. Hackmann & Jonathan T. Kolstad & Amanda E. Kowalski, 2015. "Adverse Selection and an Individual Mandate: When Theory Meets Practice," American Economic Review, American Economic Association, vol. 105(3), pages 1030-1066, March.
    7. Baily, Martin Neil, 1978. "Some aspects of optimal unemployment insurance," Journal of Public Economics, Elsevier, vol. 10(3), pages 379-402, December.
    8. 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.
    9. 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 129-156, February.
    10. Ham, John C. & Shore-Sheppard, Lara, 2005. "The effect of Medicaid expansions for low-income children on Medicaid participation and private insurance coverage: evidence from the SIPP," Journal of Public Economics, Elsevier, vol. 89(1), pages 57-83, January.
    11. Congressional Budget Office, 2010. "The Budget and Economic Outlook: An Update," Reports 21670, Congressional Budget Office.
    12. Congressional Budget Office, 2010. "The Budget and Economic Outlook: An Update," Reports 21670, Congressional Budget Office.
    13. Aaron S. Yelowitz, 1995. "The Medicaid Notch, Labor Supply, and Welfare Participation: Evidence from Eligibility Expansions," The Quarterly Journal of Economics, Oxford University Press, vol. 110(4), pages 909-939.
    14. Miller, Sarah, 2012. "The effect of insurance on emergency room visits: An analysis of the 2006 Massachusetts health reform," Journal of Public Economics, Elsevier, vol. 96(11), pages 893-908.
    15. 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," American Economic Review, American Economic Association, vol. 102(3), pages 498-501, May.
    16. Lo Sasso, Anthony T. & Buchmueller, Thomas C., 2004. "The effect of the state children's health insurance program on health insurance coverage," Journal of Health Economics, Elsevier, vol. 23(5), pages 1059-1082, September.
    17. David Card & Lara D. Shore-Sheppard, 2004. "Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low-Income Children," The Review of Economics and Statistics, MIT Press, vol. 86(3), pages 752-766, August.
    18. Dhaval Dave & Sandra L. Decker & Robert Kaestner & Kosali I. Simon, 2015. "The Effect of Medicaid Expansions in the Late 1980s and Early 1990s on the Labor Supply of Pregnant Women," American Journal of Health Economics, University of Chicago Press, vol. 1(2), pages 165-193, Spring.
    19. Raj Chetty & Adam Guren & Day Manoli & Andrea Weber, 2011. "Are Micro and Macro Labor Supply Elasticities Consistent? A Review of Evidence on the Intensive and Extensive Margins," American Economic Review, American Economic Association, vol. 101(3), pages 471-475, May.
    20. Congressional Budget Office, 2010. "The Budget and Economic Outlook: An Update," Reports 21670, Congressional Budget Office.
    21. repec:cbo:report:216708 is not listed on IDEAS
    22. Gruber, Jonathan, 1994. "The Incidence of Mandated Maternity Benefits," American Economic Review, American Economic Association, vol. 84(3), pages 622-641, June.
    23. Congressional Budget Office, 2010. "The Budget and Economic Outlook: An Update," Reports 21670, Congressional Budget Office.
    24. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, Oxford University Press, vol. 111(2), pages 391-430.
    25. 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.
    26. 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.
    27. Congressional Budget Office, 2010. "The Budget and Economic Outlook: An Update," Reports 21670, Congressional Budget Office.
    28. Congressional Budget Office, 2010. "The Budget and Economic Outlook: An Update," Reports 21670, Congressional Budget Office.
    29. repec:cbo:report:216707 is not listed on IDEAS
    30. repec:cbo:report:216706 is not listed on IDEAS
    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. Thomas Buchmueller & John C. Ham & Lara D. Shore-Sheppard, 2015. "The Medicaid Program," NBER Chapters, in: Economics of Means-Tested Transfer Programs in the United States, Volume 1, pages 21-136, National Bureau of Economic Research, Inc.
    2. David Lang & Kevin J. Lansing, 2010. "Forecasting growth over the next year with a business cycle index," FRBSF Economic Letter, Federal Reserve Bank of San Francisco, issue sep27.
    3. Hess Chung & Jean‐Philippe Laforte & David Reifschneider & John C. Williams, 2012. "Have We Underestimated the Likelihood and Severity of Zero Lower Bound Events?," Journal of Money, Credit and Banking, Blackwell Publishing, vol. 44(s1), pages 47-82, February.
    4. Marcus Dillender, 2017. "English Skills and the Health Insurance Coverage of Immigrants," American Journal of Health Economics, University of Chicago Press, vol. 3(3), pages 312-345, Summer.
    5. David Yaskewich, 2015. "Dependent Health Insurance Laws and College Enrollment: Is There Evidence of College Lock?," Journal of Family and Economic Issues, Springer, vol. 36(4), pages 557-569, December.
    6. 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.
    7. Johanna Catherine Maclean & Brendan Saloner, 2018. "Substance Use Treatment Provider Behavior and Healthcare Reform: Evidence from Massachusetts," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 76-101, January.
    8. Dolores De la Mata & Carlos Felipe Gaviria, 2015. "Losing Health Insurance When Young: Impacts on Usage of Medical Services and Health," CINCH Working Paper Series 1508, Universitaet Duisburg-Essen, Competent in Competition and Health, revised Aug 2015.
    9. Frean, Molly & Gruber, Jonathan & Sommers, Benjamin D., 2017. "Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act," Journal of Health Economics, Elsevier, vol. 53(C), pages 72-86.
    10. David W. Brown & Amanda E. Kowalski & Ithai Z. Lurie, 2015. "Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts"," Cowles Foundation Discussion Papers 1979, Cowles Foundation for Research in Economics, Yale University.
    11. Gaviria Garcés, Carlos Felipe & De la Mata, Dolores, 2016. "Losing health insurance when young: Impacts on usage of medical services and health in Colombia," Papeles en Salud 015113, Ministerio de Salud y Protección Social.
    12. Hamersma, Sarah & Kim, Matthew, 2013. "Participation and crowd out: Assessing the effects of parental Medicaid expansions," Journal of Health Economics, Elsevier, vol. 32(1), pages 160-171.
    13. Lincoln H. Groves, 2020. "Still “Saving Babies”? The Impact Of Child Medicaid Expansions On High School Completion Rates," Contemporary Economic Policy, Western Economic Association International, vol. 38(1), pages 109-126, January.
    14. Sarah Hamersma & Matthew Kim & Brenden Timpe, 2019. "The Effect Of Parental Medicaid Expansions On Children'S Health Insurance Coverage," Contemporary Economic Policy, Western Economic Association International, vol. 37(2), pages 297-311, April.
    15. Dhaval Dave & Sandra L. Decker & Robert Kaestner & Kosali I. Simon, 2015. "The Effect of Medicaid Expansions in the Late 1980s and Early 1990s on the Labor Supply of Pregnant Women," American Journal of Health Economics, MIT Press, vol. 1(2), pages 165-193, Spring.
    16. Marianne P. Bitler & Madeline Zavodny, 2014. "Medicaid: A Review of the Literature," NBER Working Papers 20169, National Bureau of Economic Research, Inc.
    17. Sean Lyons, 2017. "Are Employer Mandates to Offer Health Insurance Effective in Reducing Subsidized Coverage Crowd-Out of Employer-Sponsored Insurance?," American Journal of Health Economics, MIT Press, vol. 3(3), pages 370-391, Summer.
    18. Hamersma, Sarah & Maclean, Johanna Catherine, 2021. "Do expansions in adolescent access to public insurance affect the decisions of substance use disorder treatment providers?," Journal of Health Economics, Elsevier, vol. 76(C).
    19. Phillip B. Levine & Robin McKnight & Samantha Heep, 2009. "Public Policy, Health Insurance and the Transition to Adulthood," NBER Working Papers 15114, National Bureau of Economic Research, Inc.
    20. Barbaresco, Silvia & Courtemanche, Charles J. & Qi, Yanling, 2015. "Impacts of the Affordable Care Act dependent coverage provision on health-related outcomes of young adults," Journal of Health Economics, Elsevier, vol. 40(C), pages 54-68.

    More about this item

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • J20 - Labor and Demographic Economics - - Demand and Supply of Labor - - - General

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:nbr:nberwo:19220. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    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: (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

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

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.