Revisiting Medicaid Expansion and Work: Labor Supply, Coverage, and Economic Adjustment Across Populations

Session Submission Type: Panel

Abstract

More than a decade after the Affordable Care Act expanded Medicaid eligibility, and as policymakers prepare for the upcoming federally mandated work requirements under the One Big Beautiful Bill Act (OBBBA), a central policy question remains unresolved: how does access to public health insurance shape labor market behavior? This panel brings together four papers by economists and health policy researchers examining the labor market effects of Medicaid expansion across distinct populations and institutional settings in the United States. Using complementary empirical strategies, the papers provide new evidence on how public coverage interacts with employment, occupational choice, and economic outcomes. The papers also set the stage for the policy debates now emerging around work requirements and the future design of public insurance for low-income adults.

The first paper examines how Medicaid expansion affects access to employer-sponsored insurance (ESI) among low-income workers. Using data from the Current Population Survey’s Annual Social and Economic Supplement (ASEC) and a triple-difference design, the authors show that coverage gains are concentrated among individuals in occupations and industries with historically low ESI offer rates, and that expansion is associated with increased representation of such jobs among Medicaid-covered workers. The second paper studies labor supply responses among farm households using nationally representative data and modern difference-in-differences methods. The paper shows that while Medicaid expansion significantly increases insurance enrollment, there is no evidence of changes in labor supply. The third paper examines employment outcomes among another vulnerable population using an event-study design and data from the Survey of Income and Program Participation (SIPP). Among working-age adults with disabilities, the paper finds employment increases among younger and newly disabled individuals, but declines among older individuals with persistent disabilities. The final paper extends the analysis to the macro level, showing that Medicaid expansion improves labor market outcomes within the healthcare sector while having limited effects on aggregate GDP.

Policy Area

• Health Policy

Chair

• David Anderson, University of South Carolina

Discussants

• Hyesung Oh, California State University, Long Beach

• Kristine Jenny Hahm, University of Texas, Dallas

Organizer

• Salpy Kanimian, Brown University

Individual Presentations

• Access to Employer-Health Insurance, or Not, Among the Medicaid Eligible Workforce - Presenting Author: Joseph Benitez, University of Kentucky

• Public Healthcare Access and the Labor Supply of Farmers - Presenting Author: Laura Montenovo, Purdue University

• Medicaid Expansion and Employment Outcomes for Working Age Adults with Disabilities - Presenting Author: Sungjin Lee, San Diego State University

• Economic Effects of Medicaid Expansion - Presenting Author: Liam Malloy, University of Rhode Island; Non-Presenting Co-Author: Shanna Pearson-Merkowitz, University of Maryland, College Park