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    Does Employer-Provided Health Insurance Constrain Labor Supply Adjustments to Health Shocks? New Evidence on Women Diagnosed with Breast Cancer, by Cathy J. Bradley, David Neumark and Scott Barkowski (The National Bureau of Economic Research)

    Employment-contingent health insurance creates incentives for ill workers to remain employed at a sufficient level (usually full-time) to maintain access to health insurance coverage. We study employed married women, newly diagnosed with breast cancer, comparing labor supply responses to breast cancer diagnoses between women dependent on their own employment for health insurance and women with access to health insurance through their spouse’s employer. We find evidence that women more dependent on their own job for health insurance reduce their labor supply by less after a diagnosis of breast cancer – the estimate difference is about 5.5 to 7 percent. Women’s subjective responses to questions about working more to maintain health insurance are consistent with the conclusions from observed behavior.

    The Impact of the Affordable Care Act on Medicare Advantage Plan Availability and Enrollment, by Christopher C. Afendulis, Mary Beth Landrum and Michael E. Chernew (Health Services Research)

    Objective: To assess the impact of the Patient Protection and Affordable Care Act’s (ACA) changes in Medicare Advantage (MA) payment rates on the availability of and enrollment in MA plans.

    Data Sources: Secondary data on MA plan offerings, contract offerings, and enrollment by state and county, in 2010–2011.

    Study Design: We estimated regression models of the change in the number of plans, the number of contracts, and enrollment as a function of quartiles of FFS spending and pre-ACA MA payment generosity. Counties in the lowest quartile of spending are treated most generously by the ACA.

    Principal Findings: Relative to counties in the highest quartile of spending, the number of plans in counties in the first, second, and third quartiles rose by 12 percent, 7.6 percent, and 5.4 percent, respectively. Counties with more generous MA payment rates before the ACA lost significantly more plans. We did not find a similar impact on the change in contracts or enrollment.

    Conclusions: The ACA-induced MA payment changes reduced the number of plan choices available for Medicare beneficiaries, but they have yet affected enrollment patterns.

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