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The Impact of Job Displacement on Health Insurance Status in the post-ACA Era

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  • Katsuhiko Nishiyama

    (Osaka School of International Public Policy, The University of Osaka)

Abstract

This paper examines whether insurance sources expanded under the Affordable Care Act (ACA), particularly health insurance marketplaces and Medicaid, compensate for the loss of employer-sponsored health insurance (ESHI) following job displacement. Using monthly data from the 2014--2016 Survey of Income and Program Participation, I estimate duration-specific effects of displacement on each coverage source with a difference-in-differences design. ESHI coverage falls by 15 to 18 percentage points within a few months of displacement, with only slight recovery over the following year. Medicaid enrollment increases modestly, driven entirely by workers in expansion states where coverage increases exceed 7 percentage points. Directly purchased private insurance shows no discernible response despite marketplace availability and premium subsidies, and this holds across income levels. These findings indicate that ACA marketplace reforms in the sample period provide limited protection for displaced workers.

Suggested Citation

  • Katsuhiko Nishiyama, 2026. "The Impact of Job Displacement on Health Insurance Status in the post-ACA Era," OSIPP Discussion Paper 26E001, Osaka School of International Public Policy, Osaka University.
    • Handle: RePEc:osp:wpaper:26e001
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    File URL: https://www.osipp.osaka-u.ac.jp/archives/DP/2026/DP2026E001.pdf
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    References listed on IDEAS

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    3. Nicholas A. Jolly & Brian J. Phelan, 2017. "The Long-Run Effects of Job Displacement on Sources of Health Insurance Coverage," Journal of Labor Research, Springer, vol. 38(2), pages 187-205, June.
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    5. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    6. East, Chloe N. & Simon, David, 2024. "The safety net and job loss: How much insurance do public programs provide?," Journal of Public Economics, Elsevier, vol. 238(C).
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    Keywords

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    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • J64 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Unemployment: Models, Duration, Incidence, and Job Search

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