Did Individual Insurance Market Reforms Under the Affordable Care Act Affect Labor Force Participation Decisions Among Older Workers? Open Access
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The Affordable Care Act (ACA) included reforms to increase the availability and affordability of private, individual health insurance. This dissertation examines how these changes affected labor force participation decisions of older workers not yet eligible for Medicare, particularly retirement decisions. Telephone interviews conducted in 2014 with thirty 45-64 year-olds found access to affordable individual insurance coverage was a factor (though not the primary factor) in labor force participation decisions by overcoming barriers to coverage related to health, cost, and employment status, and increased flexibility to work part-time, retire, or start a business. Difference-in-differences analysis of the Current Population Survey (2010-2017) showed that among 55-64 year-olds, living in states where individual health insurance market regulations to increase affordability and accessibility were new under the ACA was associated with a small but statistically significant increase in likelihood of retirement. This increase ranged from 1.6-2.8 percentage points compared to those living in states that already had these regulations. Taken together, findings show the availability and affordability of individual health insurance played a role in the labor force participation decisions of older adults interviewed, suggesting similar decision-making processes may explain a slight increase in retirement in the CPS analysis among this population in states where the ACA introduced new regulations to increase the availability and affordability of individual insurance.