The Effect of the Affordable Care Act on Entrepreneurship among Older Adults
One goal of the Affordable Care Act (ACA) was to enable entrepreneurship by increasing access to non-employer-based health insurance. We evaluate the extent to which the ACA was successful at this, providing some of the first estimates of the effect of the main provisions of the ACA on entrepreneurship. We are the first to focus specifically on older adults, whose higher average health costs and health insurance premiums make health insurance more salient to their labor market decisions. We do so using data from the American Community Survey and a difference-in-difference strategy, taking advantage of Medicare-eligibles as a control group less affected by the ACA. We find that the ACA led to a 3–4% increase in self-employment. We find similar increases in the likelihood of being self-employed in an incorporated business and of generating at least $5000 in business income, as well as a 9% increase in the likelihood of being self-employed full time. By lowering the cost of non-employer health insurance policies to older adults, the ACA appears to have eased their transition from employment to self-employment.
KeywordsHealth insurance Affordable Care Act Job-lock Self-employment Entrepreneurship Labor supply Public insurance
JEL ClassificationI1 J2
- Ahmad, Nadim, and Anders Hoffmann. 2008. A Framework for Addressing and Measuring Entrepreneurship. OECD Statistics Working Paper No. 2. http://dx.doi.org/10.2139/ssrn.1090374.
- Barber III, Dennis and Thomas Kavoori. 2018. The Affordable Care Act, state exchanges and the self-employed in the USA. Journal of Small Business & Entrepreneurship. https://doi.org/10.1080/08276331.2018.1424987 (forthcoming).
- Becker, Thealexa and Tuzeman, Didem. 2015. Self-Employment and Health Care Reform: Evidence from Massachusetts. Federal Reserve Bank of Kansas City working paper.Google Scholar
- Blumberg, Linda, Sabrina Corlette, and Kevin Lucia. 2013. The Affordable Care Act: Improving Incentives for Entrepreneurship and Self-Employment. Urban Institute working paper.Google Scholar
- Blume-Kohout, Margaret. 2018. The Affordable Care Act and Women’s Self-Employment. Colgate University working paper.Google Scholar
- Currie, Janet, and Brigitte Madrian. 1999. Health, Health Insurance and the Labor Market. In Handbook of Labor Economics, vol. 3, ed. Orley Ashenfelter and David Card, 3309–3415. Amsterdam: Elsevier-North Holland.Google Scholar
- Dave, D., I. Rashad, and J. Spasojevic. 2008. The Effects of Retirement on Physical and Mental Health Outcomes. Southern Economic Journal 75(2): 497.Google Scholar
- Duggan, Mark, Gopi Shah Goda, Emilie Jackson. 2017. The Effects of the Affordable Care Act on Health Insurance Coverage and Labor Market Outcomes. NBER Working Paper No. 23607.Google Scholar
- Fairlie, Robert, Kanika Kapur, and Susan Gates. 2011. Is Employer-Based Health Insurance a Barrier to Entrepreneurship? Journal of Health Economics. Google Scholar
- Furman, Jason. 2014. Six Economic Benefits of the Affordable Care Act. https://www.whitehouse.gov/blog/2014/02/06/six-economic-benefits-affordable-care-act.
- Gruber, Jonathan. 2000. Health Insurance and the Labor Market in Joseph Newhouse and Anthony Culyer, eds., The Handbook of Health Economics. Amsterdam: North Holland, p. 645–706.Google Scholar
- Gruber, Jonathan, and Brigitte Madrian. 2004. Health Insurance, Labor Force Participation, and Job Choice: A Critical Review of the Literature. In Health Policy and the Uninsured, ed. Catherine McLaughlin. New York: Urban Institute Press.Google Scholar
- Hipple, Steven “Self-employment in the United States,” Monthly Labor Review, Bureau of Labor Statistics, p. 17–32, September 2010.Google Scholar
- Niu, Xiaotong. 2014. Health Insurance and Self-Employment: Evidence from Massachusetts. Industrial & Labor Relations Review. Google Scholar
- Ruggles, Steven, Katie Genadek, Ronald Goeken, Josiah Grover, and Matthew Sobek. Integrated Public Use Microdata Series: Version 7.0 [dataset]. Minneapolis: University of Minnesota, 2017. https://doi.org/10.18128/D010.V7.0.