Equilibrium Labor Market Search and Health Insurance Reform, Third Version

Naoki Aizawa () and Hanming Fang
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Naoki Aizawa: Department of Economics, University of Wisconsin-Madison

PIER Working Paper Archive from Penn Institute for Economic Research, Department of Economics, University of Pennsylvania

Abstract: We present and empirically implement an equilibrium labor market search model where risk averse workers facing medical expenditure shocks are matched with ï¬ rms making health insurance coverage decisions. Our model delivers a rich set of predictions that can account for a wide variety of phenomenon observed in the data including the correlations among ï¬ rm sizes, wages, employer-sponsored health insurance offering rates, turnover rates and workers’ health compositions. We estimate our model by Generalized Method of Moments using a combination of micro datasets including the Survey of Income and Program Participation, the Medical Expenditure Panel Survey and the Kaiser Family Employer Health Insurance Beneï¬ ts Survey. We use our estimated model to evaluate the equilibrium impact of the 2010 Affordable Care Act (ACA) and compare it with other health care reform proposals. We also use the estimates of the early impact of the ACA as a model validation. We ï¬ nd that the full implementation of the ACA would reduce the uninsured rate among the workers in our estimation sample from about 21.3% in the pre-ACA benchmark economy to 6.6%. We also ï¬ nd that income-based premium subsidies for health insurance purchases from the exchange play an important role for the sustainability of the ACA; without the premium subsidies, the uninsured rate would be around 15.8%. In contrast, as long as premium subsidies and health insurance exchanges with community ratings stay intact, ACA without the individual mandate, or without the employer mandate, or without both mandates, could still succeed in reducing the uninsured rates to 11.4%, 7.5% and 12.9% respectively.

Keywords: Health; Health Insurance; Health Care Reform; Labor Market Equilibrium (search for similar items in EconPapers)
JEL-codes: G22 I11 I13 J32 (search for similar items in EconPapers)
Pages: 84 pages
Date: 2018-06-11, Revised 2018-06-11
New Economics Papers: this item is included in nep-dge, nep-hea and nep-ias
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Citations: View citations in EconPapers (1)

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