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Self-employment and health care reform: evidence from Massachusetts

Thealexa Becker and Didem Tuzemen ()

No RWP 14-16, Research Working Paper from Federal Reserve Bank of Kansas City

Abstract: We study the e ect of the Massachusetts health care reform on the uninsured rate and the self-employment rate in the state. The reform required all individuals to obtain health insurance, required most employers to o er health insurance to their employees, formed a private marketplace that o ered subsidized health insurance options and ex- panded public insurance. We examine data from the Current Population Survey (CPS)for 1994-2012 and its Annual Social and Economic (ASEC) Supplement for 1996-2013. We show that the reform led to a dramatic reduction in the state's uninsured rate due to increased enrollment in both public and private health insurance. Estimation results from di erence-in-di erences models and the synthetic control method indicate that the aggregate self-employment rate was higher in the state after the implementation of the reform. We conclude that easier access to health insurance encouraged self-employment in Massachusetts. There are many similarities between the Massachusetts health care reform and the national health care reform, the Patient Protection and Affordable Care Act (PPACA). Based on Massachusetts' experience, the PPACA will lower the national uninsured rate and may lead to a higher self-employment rate in the nation.

Keywords: Massachusetts health care reform; Patient Protection and Affordable Care Act; self-employment; health insurance; difference-in-differences model; synthetic control method (search for similar items in EconPapers)
JEL-codes: C10 C15 E24 I13 I18 I38 L26 (search for similar items in EconPapers)
Pages: 50 pages
Date: 2014-11-25
New Economics Papers: this item is included in nep-ent, nep-hea, nep-ias, nep-mac, nep-mfd and nep-pke
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