How Have Workers Fared Under the ACA?

Urban Institute - U.S. Health Reform Monitoring and Impact, November 2018

15 Pages Posted: 7 Aug 2019

Date Written: July 30, 2019


Whether the coverage provisions under the Affordable Care Act (ACA) would lead to adverse labor market consequences in the form of reduced employment, hours worked, or earnings has been the subject of substantial debate and analysis. This brief assesses whether coverage gains from 2010 to 2016 were associated with changes in labor market outcomes across occupations. Using data from the American Community Survey and the Current Population Survey, we show how employment, hours worked per week, and weekly earnings changed, by occupation group, and how these changes differed for occupations experiencing larger and smaller coverage gains under the ACA. We also examine whether occupations experiencing increased coverage through nonemployment sources (i.e., through Medicaid or individual plans purchased on the ACA’s Marketplace exchanges) also experienced offsetting declines in ESI coverage. We find that predictions that the coverage provisions of the ACA would lead to reduced employment, work hours, and earnings did not materialize, nor did predictions that employer-based coverage rates would fall as employers dropped coverage.

Keywords: ACA, Employment, Part-Time, Labor Suppy, Labor Demand, Health Insurance

JEL Classification: I10, I11, J01, J08, J20

Suggested Citation

Gangopadhyaya, Anuj and Garrett, A. Bowen and Dorn, Stan, How Have Workers Fared Under the ACA? (July 30, 2019). Urban Institute - U.S. Health Reform Monitoring and Impact, November 2018, Available at SSRN:

Anuj Gangopadhyaya

Urban Institute ( email )

2100 M Street, NW
Washington, DC 20037
United States

A. Bowen Garrett (Contact Author)

Urban Institute ( email )

500 L'Enfant Plaza SW
Washington, DC 20024
United States


Stan Dorn

Families USA ( email )

United States

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