Affordable Care Act and the Labor Market

平价医疗法案和劳动力市场奥巴马总统于2010年3月签署了平价医疗法案，通常被称为ACA，使之成为法律。这是自1965年联邦医疗保险制度建立以来，美国医疗保险和医疗保健市场最重大的改革。ACA的重要组成部分包括：i)要求所有个人必须购买医疗保险，否则将面临处罚(个人强制令)；ii)要求全职雇员超过50人的雇主提供医疗保险或支付罚款(雇主强制令)；iii)建立受监管的州医疗保险交易所，失业人员、自营职业者和未被雇主赞助的医疗保险覆盖的工人可以购买医疗保险，收入低于联邦贫困线400%的家庭的个人可以获得基于收入的补贴。对美国医疗保险制度的这种全面改革可能会在许多方面对劳动力市场产生重要的均衡效应，其中两个是本研究提案中描述的两个项目的重点。在题为“联合家庭劳动力供应和医疗保险改革”的项目1中，PI研究了ACA对公司提供配偶医疗保险福利的可能影响，在一个平衡模型中，该模型是家庭联合劳动力供应和内生公司对医疗保险提供的决策，包括是否包括配偶医疗保险。本研究的目的是促进文献的发展和经验性地实施与健康和健康保险的均衡联合家庭劳动力搜索模型。采购经理人指数提供了对ACA对公司保险产品和家庭结果的影响的量化评估。在项目2中，题为“内生技术选择和医疗保险的均衡劳动力市场搜索”研究了ACA可能如何影响公司的技术选择，认识到ACA中的法规，特别是雇主的强制要求，可能会导致公司转向新技术(例如，任何增加自动化的技术)，这些技术需要大量的前期投资，但可以减少对低技能劳动力的需求。PI提出了一个均衡劳动力市场模型，在该模型中，不同类型的公司和工人在摩擦环境中匹配，公司同时选择技术和薪酬方案(包括工资和医疗保险)。他们使用估计的模型来模拟企业将如何应对ACA，重点放在他们的技术选择以及随后对非熟练工人失业率和福利的影响上。该研究提案将在方法论上推进以联合家庭劳动力搜索(项目1)和内生技术选择(项目2)为特征的劳动力市场均衡模型的建模和实证实施。实证结果可以为劳动力市场对平价医疗法案的反应提供事前评估，这不仅可以对更广泛地了解ACA的影响起到重要作用，而且可能会影响未来如何改进医疗保险制度。

Affordable Care Act and the Labor MarketPresident Obama signed the Affordable Care Act, commonly referred to as the ACA, into law in March 2010. It represents the most significant reform to the U.S. health insurance and health care market since the establishment of Medicare in 1965. Important components in the ACA include: i) mandates that all individuals must have health insurance or face a penalty (individual mandate); ii) employers with more than 50 full-time employees will be required to provide health insurance or pay a fine (employer mandate); iii) the establishment of regulated state-based health insurance exchanges where the unemployed, the self-employed and workers who are not covered by employer-sponsored health insurance can purchase health insurance with income-based subsidies available to individuals in households whose income is below 400 percent of the federal poverty line. Such a sweeping reform to the U.S. health insurance system is likely to have important equilibrium effects on the labor market in many dimensions, two of which are the focus of the two projects described in this research proposal. In Project 1, titled "Joint Household Labor Supply and Health Insurance Reform", the PIs study the likely effect of the ACA on firms' decisions to offer spousal health insurance benefits in an equilibrium model of joint household labor supply and endogenous firm decisions on the health insurance offerings, including whether to include spousal health insurance. The research aims to advance the literature in developing and empirically implementing an equilibrium joint household labor search model with health and health insurance. The PIs provide a quantitative assessment of the impact of the ACA on firms' insurance offerings and on household outcomes. In Project 2, titled "Equilibrium Labor Market Search with Endogenous Technology Choice and Health Insurance", is a study of how the ACA may impact firms' technology choices, recognizing that the regulations in the ACA, particularly the employer mandate, may lead firms to switch to new technology (e.g., any technology that increases automation), that require substantial up-front investment but can reduce the demand for low skill labor. The PIs propose an equilibrium labor market model in which heterogeneous firms and workers are matched in a frictional environment, and firms choose both technology and compensation packages (including wage and health insurance offering). They use the estimated model to simulate how firms will respond to the ACA, with a focus on their technology choices and on the subsequent effect on the unemployment rate and welfare of unskilled workers. The research proposal will methodologically advance the modeling and empirical implementation of equilibrium models of the labor market that features joint household labor search (Project 1) and endogenous technology choice (Project 2). The empirical results can provide an ex ante evaluation of the labor market responses to the Affordable Care Act, and these can play an important role in not only obtaining a broader understanding the effects of the ACA, but also possibly affect how to improve the health insurance system in the future.