The Affordable Care Act (ACA) includes several provisions designed to expand insurance coverage that also alter the tie between employment and health insurance. In this paper, we exploit variation across geographic areas in the potential impact of the ACA to estimate its effect on health insurance coverage and labor market outcomes in the first two years after the implementation of its main features. Our measures of potential ACA impact come from pre-existing population shares of uninsured individuals within income groups that were targeted by Medicaid expansions and federal subsidies for private health insurance, interacted with each state’s Medicaid expansion status. Our findings indicate that the majority of the increase in health insurance coverage since 2013 is due to the ACA and that areas in which the potential Medicaid and exchange enrollments were higher saw substantially larger increases in coverage. While labor market outcomes in the aggregate were not significantly affected, our results indicate that labor force participation reductions in areas with higher potential exchange enrollment were offset by increases in labor force participation in areas with higher potential Medicaid enrollment

中文翻译：

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《平价医疗法案》对健康保险覆盖率和劳动力市场成果的影响

《平价医疗法案》（ACA）包括旨在扩大保险范围的若干条款，这些条款也改变了就业与健康保险之间的联系。在本文中，我们在ACA的主要功能实施后的头两年内，利用ACA的潜在影响中的不同地区来估计其对健康保险覆盖率和劳动力市场成果的影响。我们对潜在ACA影响的衡量标准来自收入类别中未保险个人的既有人口份额，这些人群是医疗补助扩张和联邦对私人健康保险的补贴的目标，并与每个州的医疗补助扩张状况相互影响。我们的调查结果表明，自2013年以来，健康保险覆盖率的增长大部分归因于ACA，而潜在医疗补助和交换生人数较高的领域的覆盖率大幅增长。虽然总体上劳动力市场的成果并未受到显着影响，但我们的结果表明，潜在交流参与人数较高的地区劳动力参与人数的减少被潜在医疗补助人数较高的地区的劳动力参与人数的增加所抵消