How work, health and insurance may change post-ACA


Long-run labor market trends have not been favorable to many workers in the United States.

Changing technology and globalization have undermined the demand for the skills needed in traditional middle- and low-wage occupations, leading to stagnant wage growth and a gradual, but steady erosion of employer-sponsored health insurance.

The Affordable Care Act reversed the decline in coverage, increasing the number of people with insurance by more than 20 million. The bulk of this coverage was not tied to employment, although employer-sponsored plans remain the most importance source of coverage for non-elderly Americans.

Given the link between health insurance and the labor market, proposals to dismantle some provisions of Obamacare have important consequences for the labor market, said Thomas Buchmueller, professor of business economics and public policy.

Buchmueller and Robert Valletta, an economist with the Federal Reserve Bank of San Francisco, analyzed the changing landscapes for work, health and health insurance coverage for the February issue of Health Affairs.

“Whatever happens with the ACA, employer-sponsored insurance will likely remain a key source of health coverage in the United States,” Buchmueller said. “But the same labor market forces that caused coverage to decline before the law went into effect are not going away.”

Other long-run trends and recent developments are likely to increase the strain on the employer-sponsored system, he said. The aging of the workforce will raise health spending, while the rise of contract work and the “gig economy” will mean fewer and fewer workers employed full-time in wage and salary positions.

“The ACA strengthened the safety net and should mitigate some of the negative aspects of the labor market,” Buchmueller said. “Legislative reversals may intensify the barriers many working-age people face as they seek affordable health care.”



  1. Jill B.
    on February 8, 2017 at 7:38 am

    The Record: could you please use the proper name of the Affordable Care Act and get away from calling it ObamaCare? The term ObamaCare seems to confuse some folks. Thanks.

    • D. Addison
      on February 8, 2017 at 8:34 am

      Thank you Jill B. I truly believe that is the reason some people do not like it. If folks had consistently called it ACA throughout the implementation of the healthcare law, the same people opposing the law most certainly would have been all for it!

      • Jill B.
        on February 9, 2017 at 7:44 am

        And we might not be in the mess we are currently in. We need to hound the press to call it what it is: ACA.

    • A. Wahby
      on February 8, 2017 at 12:54 pm

      One-Third of Americans Don’t Know That Obamacare and the Affordable Care Act Are the Same Thing. Why I’m not surprised?

    • Gary W.
      on February 8, 2017 at 10:09 pm

      If the Affordable Care Act is “Obamacare”, then Medicare should be “Johnsoncare”. Actually, more properly they should both be called “Congresscare” since both pieces of legislation were passed by Congress, not the President.

      A lot of people, including me, will be harmed if the ACA is significant changed.

      I was so proud to be an American when, for the first time in our history, everyone person had minimum healthcare. Oh well, I did not vote for the candidate that got the least popular votes.

  2. Sandra Raymond
    on February 9, 2017 at 1:54 pm

    I agree–if the ACA had not been dubbed “Obamacare”, we wouldn’t be having this issue. I can’t tell you how many people I know who did not have insurance. They were just hoping they stayed healthy and avoided catastrophic illness or injury. Some couldn’t afford preventive care, leading to preventable health problems.

Leave a comment

Commenting is closed for this article. Please read our comment guidelines for more information.