The ACA Medicaid Expansions and Employment of Adults With Disabilities

The ACA Medicaid Expansions and Employment of Adults With Disabilities

Published: Dec 01, 2021
Publisher: Journal of Disability Policy Studies, vol. 32, issue 3
Key Findings
  • Our findings showed no evidence that Medicaid expansions significantly affected the employment of adults with disabilities at the national level, either overall or for most subgroups of states or individuals.
  • Our estimates were imprecise, so we cannot rule out the possibility that the expansions had an effect on employment, but that the magnitude of any such effect would have been quite modest based on our estimates.
  • It is also important to recognize that the Medicaid expansions may have affected the employment of some individuals with disabilities in ways that we cannot capture with the ACS measure of disability.

The Patient Protection and Affordable Care Act (ACA) of 2010 substantially expanded the availability of health insurance coverage, particularly for adults with disabilities. One notable change was the option for states to offer Medicaid coverage to adults with household incomes that were below 138% of the federal poverty line; most but not all states expanded Medicaid to this population. This article investigates whether states that expanded Medicaid coverage through the ACA in 2014—the first year that expansion was possible under the ACA, and the year that most states opted to expand—experienced differential changes in the employment rate of adults with disabilities relative to states that did not expand Medicaid. Using nationally representative data from the American Community Survey, we do not find evidence that the postexpansion employment trend in Medicaid expansion states was significantly different from that trend in states that did not expand Medicaid.

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