EMF21-04: Effects of Affordable Care Act (ACA) Marketplace Plans on Disability Claiming

Abstract

Health insurance marketplaces, a.k.a. “exchanges”, were established through the Affordable Care Act (ACA) to facilitate individual access to affordable health insurance following the implementation of the individual mandate. People with qualifying disabilities can alternatively obtain health insurance through Supplemental Security Income (SSI) and SSI for children programs. This study examines the relationship between the pricing of the ACA marketplace plans and disability claiming. Specifically, I focus on the effect of state-level and Geographic Rating Area (GRA)-level changes in the prices of health plan for a 30-year-old with two children on the number of SSI and SSI child applications per 10, 000 individuals at the state level and GRA level using a linear fixed-effect model. I find no statistically significant effect of the changes in the prices of a 30-year-old-with-two-children health plan on the number of disability applications per 10, 000 individuals at the state level and GRA level from the primary analyses. However, I find evidence that certain subgroup populations are less likely to apply for SSI programs if the premium of a 30-year-old-with-two-children health plan increases, such as populations living in states or GRAs with higher unemployment rates, poverty ratios, and high school graduation rates, as well as individuals living in states where a higher percentage report work limitations. I also find evidence that specific subgroup populations apply to SSI programs if the cost of the premium of a 30-year-old-with-two-children health plan increases, such as populations living in GRAs where there is a higher percentage of non-Hispanic white, reporting difficulties, and work limitations.