创业锁定与健康保险需求：来自美国平价医疗法案的证据

IF 2.9 3区管理学 Q1 INDUSTRIAL RELATIONS & LABOR

ILR Review Pub Date : 2023-11-26 DOI:10.1177/00197939231211561

Margaret E. Blume-Kohout

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引用次数: 0

摘要

大多数美国工人都有由雇主赞助和补贴的医疗保险计划。美国《平价医疗法案》（ACA）改善并扩大了非雇主医疗保险的可用性，在非团体市场中提供了对既存病症、保证发行和社区评级的保护。本研究利用 2009 年至 2018 年的全国健康访谈调查数据和差异建模方法，发现 ACA 增加了 2015 年和 2016 年对健康保险需求较高的美国成年人的自雇人数。在 30 至 64 岁的成年人中，如果他们在 ACA 实施前至少有一项可被取消的条件，并且没有通过配偶的雇主或公共项目获得健康保险的替代来源，那么他们自雇的概率会增加 1.4 至 1.8 个百分点。然而，这些影响都是短暂的。随着 2017 年和 2018 年 ACA 健康保险交易所长期可行性的不确定性增加，对保险需求较高的个人自雇的概率降至 ACA 前的水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Entrepreneurship Lock and the Demand for Health Insurance: Evidence from the US Affordable Care Act

Most US workers have health insurance plans sponsored and subsidized by their employers. The US Affordable Care Act (ACA) improved and expanded the availability of non-employer-based health insurance, with protections for pre-existing conditions, guaranteed issue, and community rating in non-group markets. Using National Health Interview Survey data for 2009 to 2018 and a difference-in-differences modeling approach, this study finds that the ACA increased self-employment in 2015 and 2016 among US adults with higher demand for health insurance. The probability of self-employment increased by 1.4 to 1.8 percentage points among adults ages 30 to 64 with at least one pre-ACA declinable condition and no alternative source of health insurance through a spouse’s employer or public programs. However, these effects were short-lived. As uncertainty about the long-term viability of the ACA’s health insurance exchanges increased in 2017 and 2018, the probability of self-employment among individuals with high demand for insurance fell to pre-ACA levels.

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来源期刊

ILR Review INDUSTRIAL RELATIONS & LABOR-

CiteScore

6.80

自引率

3.60%

发文量

期刊介绍： Issued quarterly since October 1947, the Industrial and Labor Relations Review is a leading interdisciplinary journal publishing original research on all aspects of the employment relationship. The journal also publishes reviews of some 30 books per year. This site offers an index of all articles and book reviews published since 1947, abstracts of all articles, and information about upcoming issues. At the "All Articles" and "All Book Reviews" pages, visitors can search on titles and authors. Use this site, too, to learn about upcoming articles and book reviews.