Association for Public Policy Analysis & Management

Panel: The Impact of Medicaid Expansions on Employment and Benefits

(Health Policy)

The Affordable Care Act substantially changed the availability of health insurance in the United States, and for many individuals, it decoupled the availability of coverage from employment. This became particularly salient in 2014, as states began to expand Medicaid coverage to those with incomes at or below 133 percent of the federal poverty line. By late 2016, data will be available to allow an early look at the post-Medicaid expansion impacts on employment and other benefit receipt. The first two papers will consider the impact of the ACA Medicaid expansions on employment; the first by Leung and Mas, considers the effect on “job lock,” while the second by Heim et al. considers the impact on the decision to retire. Both of these papers, as well as the third by Schimmel Hyde et al. use a difference-in-differences framework to compare states that expanded Medicaid to states that did not; one of the interesting pieces of information that will emerge from this panel is how the researchers determined their comparison sample, which will hopefully spur discussion about the effect of such decisions on measured impacts. The remaining two papers in this panel focus on another area in which the ACA Medicaid expansions might have an effect—the benefits and health insurance received by adults with disabilities. The first paper by Schimmel Hyde et al. examines whether the ACA Medicaid expansions affect the application for and receipt of federal disability benefits through SSI and SSDI, as many applicants for such benefits note the importance of the associated health insurance coverage. The final study by Gettens et al. considers the adequacy of newly available coverage for workers with disabilities using data collected from a representative sample in Massachusetts, which reformed health care prior to the ACA. The information from Massachusetts combined with the national focus of the other three studies will shed light on the types of changes that can be expected as a result of the Medicaid expansions, and the gaps in coverage that may affect employment and benefit seeking in the future.