Affordable Care Act and the Labor Market

平价医疗法案和劳动力市场总统奥巴马于2010年3月签署了平价医疗法案，通常被称为ACA。这是自1965年建立医疗保险制度以来，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）要求所有个人必须拥有医疗保险，否则将面临处罚（个人授权）; ii）拥有50名以上全职雇员的雇主将被要求提供医疗保险或支付罚款（雇主授权）; ㈢建立受监管的国家医疗保险交易所，没有参加雇主赞助的健康保险的自营职业者和工人可以购买健康保险，其家庭收入低于联邦贫困线400%的个人可以获得基于收入的补贴。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影响，其中两个方面是本研究提案中描述的两个项目的重点。在项目1“家庭劳动力供给与健康保险的联合改革”中，研究者们在家庭劳动力供给与企业关于健康保险供给（包括是否包括配偶健康保险）的内生决策的均衡模型中，研究了ACA对企业提供配偶健康保险福利的决策可能产生的影响。本研究的目的是推进文献的发展和实证实施一个均衡的联合家庭劳动力搜索模型与健康和健康保险。PI提供了ACA对公司保险产品和家庭结果影响的定量评估。在项目2中，题为“内生技术选择和健康保险的均衡劳动力市场搜索”，是一项关于ACA如何影响公司技术选择的研究，认识到ACA中的规定，特别是雇主的要求，可能导致公司转向新技术（例如，任何提高自动化的技术），这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，在这个模型中，异质性企业和工人在摩擦环境中匹配，企业选择技术和薪酬方案（包括工资和医疗保险）。他们使用估计模型来模拟企业将如何应对ACA，重点是他们的技术选择以及对失业率和非熟练工人福利的后续影响。本研究计划将在方法论上推进劳动力市场均衡模型的建模和实证实施，其特点是联合家庭劳动力搜索（项目1）和内生技术选择（项目2）。实证结果可以提供一个事前评估的劳动力市场反应的平价医疗法案，这些可以发挥重要作用，不仅获得更广泛的理解ACA的效果，而且可能会影响如何改善医疗保险制度在未来。

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.