Date of Award

May 2023

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Economics

First Advisor

Scott J. Adams

Committee Members

Scott Drewianka, John S. Heywood, Yoon Jangsu

Abstract

In the first chapter of my dissertation, I examine the effects of the Affordable Care Act Medicaidexpansion on the labor supply decisions of older workers. To investigate this, I employ a triple-differences (DDD) methodology, utilizing variations in individuals’ health insurance status and the expansion choices made by states. The results of my analysis shows that with Medicaid expansion, insured workers without retirement health insurance (RHI) decreased full-time work by 7.06 percentage points relative to those with RHI and those without any employer-sponsored coverage at all. Among those no longer working full-time, 82 percent transitioned to complete retirement. Moving on to the second chapter of my dissertation, I focus on examining the heterogeneity in the crowd-out of private health insurance by considering individuals’ levels of risk aversion in the context of Medicaid expansion under the ACA. Using the Health and Retirement Study (HRS) data, I find that Medicaid expansion led to a decrease in private coverage among risk-loving individuals by 5 percentage points; however, the expansion did not lead to any meaningful change in private coverage for risk-averse individuals. This finding suggests that risk-averse individuals are willing to keep their private coverage even though they become eligible for Medicaid. This suggests sorting into private coverage can have important implications for the effectiveness and cost of the expansion. In the third chapter of my dissertation, I estimate the causal impact of retirement on measures of health and investigate potential mechanisms. To achieve this, I disentangle the effect of retirement into two distinct components: (i) the part mediated by observable behaviors, which I measure with changes in heavy drinking, exercise habits, and smoking; and (ii) the residual part, which encompasses factors such as relief from occupational strain and the loss of a sense of purpose. Recognizing the endogeneity issue of retirement with regards to individual health status and health-related behaviors, I employ the eligibility age for social security as an instrumental variable. The comprehensive findings of my analysis indicate a beneficial overall total effect of retirement on both the physical and mental health of both females and males. Additionally, I observe that lifestyle changes triggered by retirement, particularly an increased likelihood of engaging in exercise, amplify the positive impact of retirement on the mental well-being of both female and male individuals. By engaging with these interconnected themes, my dissertation adds to the growing body of knowledge in the fields of healthcare policy, labor economics, and social well-being. Each chapter contributes unique insights and deepens our understanding of the complex dynamics at play in these domains.

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