Absence of conflict of interest.
Camilleri, S. E. (2017). The effect of the Affordable Care Act on labor transitions among older workers. In Three papers on the Affordable Care Act (Doctoral dissertation). North Carolina State University, Raleigh, NC.
- The study examined the impact of the Affordable Care Act (ACA) on the employment outcomes of older workers.
- The author used data from the Current Population Survey for 2011–2016 and regression analyses to estimate impacts.
- The study found that the ACA was not associated with employment outcomes among older workers.
- The quality of causal evidence presented in this report is moderate because the study is based on a well-implemented nonexperimental design. This means we are somewhat confident that any estimated effects are attributable to the ACA, but other factors might also have contributed.
Affordable Care Act (ACA)
Features of the Intervention
The ACA included provisions that prevented health insurance companies from refusing coverage due to pre-existing conditions, placed a cap on premiums charged to older individuals, provided subsidies to help pay for health insurance premiums, created state health insurance exchanges to help individuals buy health insurance plans, and expanded Medicaid coverage. The major provisions of the ACA went into effect in 2014.
Features of the Study
The study was a nonexperimental analysis that used statistical models to examine employment for older workers who were not eligible for Medicare (ages 60 to 64) in the three years before and after the enactment of ACA. The change over time for this group was compared to the change for older workers who were eligible for Medicare (ages 65 to 69) over this same period. The author also conducted analyses using a more narrow age range by comparing older workers ages 62 to 64 to those who are 66 to 68. The sample includes approximately 103,000 person-by-year observations from the 2011–2016 Current Population Survey March Supplement.
- The study found no difference in the change in employment status among older workers not eligible for Medicare compared to those who were eligible for Medicare following the enactment of the ACA.
Considerations for Interpreting the Findings
The time between the implementation of the main provisions of the ACA in 2014 and the study period, 2014 to 2016, is short and might not be long enough to see possible effects of the Act. There was also uncertainty about the future of the law at the time of the study, which might have dissuaded individuals from taking advantage of the Act’s provisions. Finally, the study period is shortly after an unusually severe recession, which may have eliminated some individuals’ retirement savings and influenced their decisions to stay in the workforce regardless of the availability of outside health insurance.
Causal Evidence Rating
The quality of the causal evidence is moderate because the study is based on a well-implemented nonexperimental design. This means we are somewhat confident that any estimated effects are attributable to the ACA, but other factors might also have contributed.