The Impact of Job Displacement on Health Insurance Status in the post-ACA Era

Katsuhiko Nishiyama
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Katsuhiko Nishiyama: Osaka School of International Public Policy, The University of Osaka

No 26E001, OSIPP Discussion Paper from Osaka School of International Public Policy, Osaka University

Abstract: This paper examines whether insurance sources expanded under the Affordable Care Act (ACA), particularly health insurance marketplaces and Medicaid, compensate for the loss of employer-sponsored health insurance (ESHI) following job displacement. Using monthly data from the 2014--2016 Survey of Income and Program Participation, I estimate duration-specific effects of displacement on each coverage source with a difference-in-differences design. ESHI coverage falls by 15 to 18 percentage points within a few months of displacement, with only slight recovery over the following year. Medicaid enrollment increases modestly, driven entirely by workers in expansion states where coverage increases exceed 7 percentage points. Directly purchased private insurance shows no discernible response despite marketplace availability and premium subsidies, and this holds across income levels. These findings indicate that ACA marketplace reforms in the sample period provide limited protection for displaced workers.

Keywords: Health Insurance; Job Displacement; the Affordable Care Act (search for similar items in EconPapers)
JEL-codes: I13 J64 (search for similar items in EconPapers)
Pages: 32pages
Date: 2026-02
New Economics Papers: this item is included in nep-hea
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