Medicaid Expansion and the Unemployed


Thomas C. Buchmueller

Helen Levy

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2019-29 | December 16, 2019

We examine how a key provision of the Affordable Care Act—the expansion of Medicaid eligibility—affected health insurance coverage, access to care, and labor market transitions of unemployed workers. Comparing trends in states that implemented the Medicaid expansion to those that did not, we find that the ACA Medicaid expansion substantially increased insurance coverage and improved access to health care among unemployed workers. We then test whether this strengthening of the safety net affected transitions from unemployment to employment or out of the labor force. We find no meaningful statistical evidence in support of moral hazard effects that reduce job finding or labor force attachment.

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Article Citation

Levy, Helen, Robert G. Valletta, and Thomas C. Buchmueller. 2019. “Medicaid Expansion and the Unemployed,” Federal Reserve Bank of San Francisco Working Paper 2019-29. Available at

About the Author
Robert G. Valletta
Robert G. Valletta is senior vice president and associate director of research in the Economic Research Department of the Federal Reserve Bank of San Francisco. Learn more about Robert G. Valletta