The impact of Medicaid expansion on employer provision of health insurance

Jean M. Abraham, Anne B. Royalty, Coleman Drake

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Using the 2010–2015 Medical Expenditure Panel Survey-Insurance Component, this study investigates the effect of the Affordable Care Act’s Medicaid eligibility expansion on four employer-sponsored insurance (ESI) outcomes: offers of health insurance, eligibility, take-up, and the out-of-pocket premium paid by employees for single coverage. Using a difference-in-differences identification strategy, we cannot reject the hypothesis of a zero effect of the Medicaid eligibility expansion on an establishment’s probability of offering ESI, the percentage of an establishment’s workforce that takes up coverage, or the out-of-pocket premium for single coverage. We find some evidence suggestive of an inverse relationship between the expansion of Medicaid and the percentage of an establishment’s workers eligible for ESI. In line with other employer- and individual-level studies of the effect of the ACA on employment-related outcomes, we find that employer provision of health insurance was largely unaffected by the Medicaid expansions.

Original languageEnglish (US)
Pages (from-to)1-24
Number of pages24
JournalInternational Journal of Health Economics and Management
StatePublished - Dec 2018

Bibliographical note

Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.


  • Affordable Care Act
  • Employer-sponsored health insurance
  • Medicaid
  • Premiums


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