How Workers Fared under the ACA

Many politicians, policy makers, and analysts have debated whether the Affordable Care Act (ACA) would have negative effects on the labor market, such as reducing employment, earnings, or hours worked. Building on the existing literature, we investigated how workers' coverage changed under the ACA and whether coverage gains were associated with changes in labor market outcomes across occupations through 2017.We also examined whether occupations experiencing increased coverage through non-employment sources (i.e., Medicaid or individual plans purchased on the ACA's Marketplaces) also experienced offsetting declines in employer-sponsored insurance (ESI) coverage. Finally, we investigated whether the employer mandate was associated with changes in ESI offers to workers. Among workers in occupations experiencing larger coverage gains under the ACA, we found no evidence that employment, hours worked, or earnings fell relative to workers in occupations that had little change in coverage rates over the same period. Moreover, ESI offers remained stable, even among workers in firms likely subject to the employer mandate. Overall, we found that predictions that the coverage provisions and mandates of the ACA would lead to adverse labor market effects did not materialize