The effects of the affordable care act on labor supply and other uses of time

Anna Bottasso, Gianluca Cerruti, Maurizio Conti and Elena Stancanelli ()
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Anna Bottasso: UniGe - Università degli studi di Genova = University of Genoa = Université de Gênes, CIRIEC - Centre Interuniversitaire de Recherche d'Information et d'Enseignement sur les Coopératives
Gianluca Cerruti: UniGe - Università degli studi di Genova = University of Genoa = Université de Gênes, LSE - London School of Economics and Political Science
Maurizio Conti: UniGe - Università degli studi di Genova = University of Genoa = Université de Gênes, IZA - Forschungsinstitut zur Zukunft der Arbeit - Institute of Labor Economics
Elena Stancanelli: PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement - ENPC - École nationale des ponts et chaussées - IP Paris - Institut Polytechnique de Paris, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement - ENPC - École nationale des ponts et chaussées - IP Paris - Institut Polytechnique de Paris, IZA - Forschungsinstitut zur Zukunft der Arbeit - Institute of Labor Economics

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Abstract: A vast literature studies the behavioral impacts of health care reforms, often coming to controversial conclusions. Here we examine the time allocation effects of the Affordable Care Act, also known as Obama Care, focusing on two pillars, namely Medicaid expansion, which increased access to public health insurance, and the Tax Credit Premium, subsidizing the purchase of private health insurance. Using 2012–2015 daily diary data from the American Time Use Survey, we take a difference-in-difference-in-differences approach, which exploits the cross-state variation in the timing of ACA implementation, together with differences in income eligibility thresholds, to identify the effects at stake. Considering a sample of childless adults aged 27–64, a group not eligible for public health insurance before ACA, we find that the Medicaid expansion reduced their labor supply by over an hour per day, increasing part-time work, while the Premium Tax Credit is associated with a slight increase in employment levels. The implications for other uses of time are also analyzed.

Date: 2026-04
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Published in Economia politica, 2026, 43 (1), pp.361-384. ⟨10.1007/s40888-025-00389-8⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:halshs-05662476

DOI: 10.1007/s40888-025-00389-8

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