Job Loss and Health Insurance Coverage Before and After the Affordable Care Act

We examine how the Affordable Care Act (ACA) altered the insurance consequences of involuntary job loss. Using matched event-study models with longitudinal survey data, we estimate the causal effects of displacement on insurance coverage before and after implementation of the ACA’s main provisions. Prior to 2014, job loss reduced coverage by approximately 16 percentage points, with losses persisting for more than a year. After the ACA, declines are smaller—about 10 percentage points—and recovery is faster. Gains reflect higher baseline public coverage and reduced post-displacement losses, with the largest improvements among middle income workers previously most exposed to coverage disruptions.