Abraham Jean M, Royalty Anne B, Drake Coleman
Division of Health Policy and Management, University of Minnesota, 420 Delaware Street SE, MMC 729, Minneapolis, MN, 55455, USA.
Department of Economics, Indiana University Purdue University Indianapolis, Cavanaugh Hall (CA) 509D, 425 University Boulevard, Indianapolis, IN, 46202, USA.
Int J Health Econ Manag. 2019 Dec;19(3-4):317-340. doi: 10.1007/s10754-018-9256-x. Epub 2018 Dec 15.
Using the 2010-2015 Medical Expenditure Panel Survey-Insurance Component, this study investigates the effect of the Affordable Care Act's Medicaid eligibility expansion on four employer-sponsored insurance (ESI) outcomes: offers of health insurance, eligibility, take-up, and the out-of-pocket premium paid by employees for single coverage. Using a difference-in-differences identification strategy, we cannot reject the hypothesis of a zero effect of the Medicaid eligibility expansion on an establishment's probability of offering ESI, the percentage of an establishment's workforce that takes up coverage, or the out-of-pocket premium for single coverage. We find some evidence suggestive of an inverse relationship between the expansion of Medicaid and the percentage of an establishment's workers eligible for ESI. In line with other employer- and individual-level studies of the effect of the ACA on employment-related outcomes, we find that employer provision of health insurance was largely unaffected by the Medicaid expansions.
本研究利用2010 - 2015年医疗支出面板调查 - 保险部分,调查了《平价医疗法案》中医疗补助资格扩大对四种雇主提供的保险(ESI)结果的影响:健康保险的提供、资格、参保率以及员工为单人保险支付的自付保费。采用双重差分识别策略,我们无法拒绝以下假设:医疗补助资格扩大对企业提供ESI的概率、企业参保员工的比例或单人保险的自付保费没有影响。我们发现一些证据表明,医疗补助的扩大与企业中符合ESI资格的员工比例之间存在反比关系。与其他关于《平价医疗法案》对就业相关结果影响的雇主和个人层面研究一致,我们发现雇主提供医疗保险在很大程度上不受医疗补助扩大的影响。