Essays on public policy and labor economics
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The majority of insured Americans obtain health insurance coverage through employment as a non-portable fringe benefit. The link between health insurance coverage and employment could have potential important implica- tions on workers’ labor market decisions. My dissertation consists of three chapters that contribute to the understanding of the interaction between health insurance and workers’ job mobility. My first chapter studies the effect of the state dependent coverage man- dates on the job mobility of young adults. Prior to the Affordable Care Act, many states had already implemented insurance mandates that extended the age that young adults could gain access to parental health insurance, an alternative insurance source which is not contingent on employment. If young workers with employer-sponsored insurance (ESI) are locked into less preferred jobs for fear of losing health benefits, expanded dependent coverage is expected to reduce the job lock and increase mobility. Expanded eligibility could also decrease mobility among those who are pushed out of a better matched but uninsured job in search of access to ESI (job push). Using Survey of Income and Program Participation (SIPP) 2000-2010 data, the impact of the state mandates on job mobility is identified by a triple-difference framework that exploits the state level dependent coverage variations in eligibility criteria, mandate implementation states, and mandate implementation time. Results show that expanded dependent coverage led to a 5% decrease in the mobility of workers with no ESI (job push). I find no evidence of reduced job lock. The second chapter of my dissertation extends the analysis of my first chapter to the Affordable Care Act (ACA) Dependent Coverage Mandate. The ACA Dependent Coverage Mandate was passed on March 23rd, 2010, and became effective on September 23, 2010. The mandate requires that health insurance plans that provide dependent coverage must cover dependents until the age of 26. Using SIPP 2008-2013 data, and both difference-in-difference framework and regression discontinuity design, I find consistent evidence of reduced job push and no evidence of reduced job lock. The estimated reduced job push is larger than the state analysis. The third chapter studies the impact of the ACA Medicaid expansion on childless adults’ job mobility. The ACA Medicaid expansion raised the Medi- caid income eligibility threshold to 138% of the Federal Poverty Line (FPL) for everyone including childless adults who were not the traditional beneficiaries of the Medicaid. 32 states adopted the expansion while 19 states opted out. The reform could potentially increase childless adults’ job mobility if they are “locked” in their jobs for fear of losing employer-sponsored health insurance. Using the 2011-2016 basic monthly Current Population Survey (CPS), this paper tests this hypothesis by comparing the job mobility of childless adults in expansion states to those residing in non-expansion states, before and after the expansion. Results show the existence of “job lock” effect: the ACA Medicaid expansion increased the childless adults’ job mobility by 7% - 9%, and the increase comes entirely from job-to-job transitions. I find no evidence of the “employment lock”: the availability of Medicaid did not cause childless adults to be more likely to become unemployed or leave the labor force.