Songyuan Deng

Date of Award

Fall 2019

Document Type

Open Access Dissertation


Health Services and Policy Management

First Advisor

Janice C. Probst


Medicaid expansion of Affordable Care Act (ACA) extended coverage to low-income working adults. While Medicaid expansion led to increased healthcare use and national healthcare expenditures, current studies do not examine the effects of Medicaid expansion on health status from the perspective of social roles, for example, changes in employment status. This study use data from the Current Population Survey to examine the association between Medicaid expansion and the probability to attribute part-time work or not-in-labor- force to health issues among people with family annual income no more than 138 of Federal Poverty Level, with a difference-in-differences study design. We found that 18 percent of part-time workers attributed their reasons of part-time work to health issues, that 9 percent of full-time workers attributed their reasons of subsequent part-time work to health issues, and that 10 percent of not-in-labor- force adults attributed their reasons to health issues. No significant change in employment status was associated with Medicaid expansion. This study adds to the literature as it is the first to identify health issues before employment status change in examining Medicaid expansion effects on health. Medicaid expansion alone failed to sustain labor stability through improving health status. Policy beyond the health insurance to tackle this challenge is warranted. The U.S. also needs more research on the intervention effectiveness in return-to-work.

Available for download on Thursday, December 16, 2021