Essays on the Interactions Between Health Insurance and Labor Markets, and the Role of the Affordable Care Act

Abstract

This dissertation consists of three chapters that study the interactions between health insurance and labor markets in the United States, especially in light of the Affordable Care Act (ACA) of 2010. The first chapter examines how labor market mobility affects equilibrium risk composition, premiums, and costs on the ACA health insurance marketplaces. I find that the labor market transition channel reduces adverse selection on these marketplaces: the participation from transitioners lowers average costs by 5% and effective premiums by 2%. However, total government spending on subsidies increases by 34% due to this interaction. The second chapter studies the impacts of the ACA on job mobility and how they vary by worker type. Using two complementary research designs that separately leverage MSA-level and individual-level variations in exposure to employer-sponsored insurance, I find that the ACA increased job mobility, with greater gains for less educated workers. The third chapter analyzed a survey conducted in June 2020 to provide timely insights on the effects of the Covid-19 pandemic on health insurance offering among small U.S. businesses.