The Relationship Between Unemployment and Health Insurance Coverage
Before and After the Affordable Care Act’s Coverage Expansions
Bibliographic Data
| ID | 9102497 |
|---|---|
| Authors | Joseph Benitez (0000-0002-0116-7270, University of Kentucky, corresponding author), T P Williams (0000-0002-4949-2152, University of Maryland, Baltimore County), Timothy Williams (0000-0002-4163-1998, The Hilltop Institute, University of Maryland Baltimore County, Baltimore, MD), Evan Goldstein (Division of Health, Services Management and Policy, College of Public Health, Ohio State University, Columbus, OH), Evan V Goldstein (0000-0001-7766-7450), Eric E Seiber (0000-0003-4273-067X, Division of Health, Services Management and Policy, College of Public Health, Ohio State University, Columbus, OH) |
| Year | 2021 |
| Volume | 59 |
| Issue | 9 |
| Pages | 768-777 |
| Publication date | 2021-09-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000001603 |
| PMID | 34310457 |
| OpenAlex | W3184373799 |
| Language | EN |
| Citations received | 3 |
| References cited | 27 |
OBJECTIVE: The objective of this study was to determine whether the Affordable Care Act's (ACA) major coverage expansions mitigated the impact of unemployment on health insurance coverage status. DATA SOURCE: A 2011-2019 versions of the American Community Survey developed by the University of Minnesota Integrated Public Use Microdata Series program. RESEARCH DESIGN: We use difference-in-difference-in-differences (ie, triple difference) regressions to compare changes in the short-run impacts of local unemployment rates before and after the ACA. PRINCIPAL FINDINGS: Before the ACA, rises in local unemployment were associated with uninsurance due to losses in private coverage (ie, both nongroup and employer sponsored).Following the ACA's full implementation, the link between employment and coverage was attenuated by access to publicly subsidized qualified health plans on the ACA's nongroup market, and enhanced access to Medicaid in states that expanded. Our findings suggest protections from unemployment-linked uninsured spells are largest in states that expanded Medicaid. CONCLUSIONS: Expanded access to coverage under the ACA could mitigate the adverse effects on insurance status and access to care historically linked to job loss. However, should the ACA be repealed, many households stand to lose their ability to turn to Medicaid or subsidized nongroup coverage as safety-net resources to offset the burdens of job loss
American Community Survey · Business · Demographic economics · Economic growth · Economics · Environmental health · Health care · Health insurance · Medicaid · Microdata (statistics) · Political science · Population · Public use · Subsidy · Unemployment · Employment and Welfare Studies · Food Security and Health in Diverse Populations · Healthcare Policy and Management · Medicine
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Difference-in-differences with variation in treatment timing
Medicaid Expansion and the Unemployed
Split-Sample Instrumental Variables Estimates of the Return to Schooling
Effects of the Affordable Care Act on Health Care Access and Self-Assessed Health After 3 Years
Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non‐Expansion States
The ACA Medicaid Expansion in Michigan and Financial Health
Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply
Medicaid Expansion and ACA Repeal
The Effects of the Patient Protection and Affordable Care Act on Children’s Health Coverage
| Unique citing works | 3 |
|---|---|
| Citations per year | 0,75 |
| Citation span | 2022 - 2024 (3) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 2 |