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Eastern Economic Journal

, Volume 45, Issue 1, pp 141–159 | Cite as

The Effect of the Affordable Care Act on Entrepreneurship among Older Adults

  • James Bailey
  • Dhaval Dave
Original Article

Abstract

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.

Keywords

Health insurance Affordable Care Act Job-lock Self-employment Entrepreneurship Labor supply Public insurance 

JEL Classification

I1 J2 

References

  1. 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.
  2. Bailey, James. 2017. Health Insurance and the Supply of Entrepreneurs: New Evidence from the Affordable Care Act. Small Business Economics 49(3): 627–646.  https://doi.org/10.1007/s11187-017-9856-8.CrossRefGoogle Scholar
  3. Bailey, James, and Anna Chorniy. 2016. Employed-Provided Health Insurance and Job Mobility: Did the Affordable Care Act Reduce Job Lock? Contemporary Economic Policy 34: 173–183.  https://doi.org/10.1111/coep.12119.CrossRefGoogle Scholar
  4. 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).
  5. 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
  6. 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
  7. Blume-Kohout, Margaret. 2018. The Affordable Care Act and Women’s Self-Employment. Colgate University working paper.Google Scholar
  8. Condliffe, Simon, Matt B. Saboe, and Sabrina Terrizzi. 2017. Did the ACA reduce job-lock and spur entrepreneurship? Journal of Entrepreneurship and Public Policy 6(2): 150–163.  https://doi.org/10.1108/JEPP-09-2016-0032.CrossRefGoogle Scholar
  9. 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
  10. 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
  11. 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
  12. Fairlie, Robert, Kanika Kapur, and Susan Gates. 2011. Is Employer-Based Health Insurance a Barrier to Entrepreneurship? Journal of Health Economics. Google Scholar
  13. 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.
  14. 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
  15. 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
  16. Gurley-Calvez, Tami. 2011. Will tax-based health insurance reforms help the self-employed stay in business? Contemporary Economic Policy 29(3): 441–460.  https://doi.org/10.1111/j.1465-7287.2010.00202.x.CrossRefGoogle Scholar
  17. Heim, Bradley, and Ithai Lurie. 2014. Does Health Reform Affect Self-Employment? Evidence from Massachusetts. Small Business Economics 43(4): 917–930.CrossRefGoogle Scholar
  18. Heim, Bradley, Ithai Lurie, and Kosali Simon. 2017. Did the Affordable Care Act Young Adult Provision Affect Labor Market Outcomes?. ILR Review: Analysis Using Tax Data. (forthcoming).CrossRefGoogle Scholar
  19. Heim, B.T., and L.K. Yang. 2017. The impact of the Affordable Care Act on self-employment. Health Economics 26(12): 256–273.  https://doi.org/10.1002/hec.3500.CrossRefGoogle Scholar
  20. Hipple, Steven “Self-employment in the United States,” Monthly Labor Review, Bureau of Labor Statistics, p. 17–32, September 2010.Google Scholar
  21. Madrian, Brigitte. 1994. Employment-Based Health Insurance and Job Mobility: Is There Evidence of Job-Lock? The Quarterly Journal of Economics 109(1): 27–54.CrossRefGoogle Scholar
  22. Niu, Xiaotong. 2014. Health Insurance and Self-Employment: Evidence from Massachusetts. Industrial & Labor Relations Review. Google Scholar
  23. Pauly, M.V., and R.D. Lieberthal. 2008. How risky is individual health insurance? Health Affairs 27(3): w242–w249.CrossRefGoogle Scholar
  24. 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.
  25. Wellington, A.J. 2001. Health insurance coverage and entrepreneurship. Contemporary Economic Policy 19(4): 465–478.  https://doi.org/10.1093/cep/19.4.465.CrossRefGoogle Scholar

Copyright information

© EEA 2018

Authors and Affiliations

  1. 1.Providence CollegeProvidenceUSA
  2. 2.Bentley UniversityWalthamUSA

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