New government health insurance programs may affect participation in existing safety-net benefits that provide health insurance as a secondary aim. We examine whether the outside options for health insurance made available by the Affordable Care Act affected Social Security Disability Insurance (DI) application decisions. Using the universe of U.S. individual income tax records spanning 2007-2016, we first estimate the effect of Medicaid expansions using a state difference-in-differences identification strategy, but find small and statistically insignificant estimates. However, when we estimate the effect of being eligible for high vs. low Marketplace subsidies based on geography, we find some evidence consistent with subsidies increasing DI claiming among those with prior access to Employer Sponsored Insurance, and decreasing DI claiming otherwise. Overall, we find suggestive evidence that outside options for health insurance do matter, though magnitudes are small and results are statistically precise only for Marketplace coverage.

新的政府健康保险计划可能会影响对现有安全网福利的参与，这些福利将健康保险作为次要目标。我们研究了《平价医疗法案》提供的健康保险的外部选项是否影响了社会保障残疾保险 (DI) 的申请决定。使用 2007-2016 年美国个人所得税记录的范围，我们首先使用州差异识别策略估计医疗补助扩张的影响，但发现小且统计上不显着的估计。然而，当我们根据地理位置估计有资格获得高与低市场补贴的影响时，我们发现一些证据与补贴增加了那些先前获得雇主赞助保险的人的 DI 索赔一致，并减少 DI 声称否则。总体而言，我们发现有暗示性的证据表明，健康保险的外部选择确实很重要，尽管幅度很小，而且结果仅在市场覆盖范围内在统计上是准确的。