How Does Health Insurance Affect Firm Employment and Performance? Evidence from Obamacare
利用奥巴马医改（PPACA）通过前后的企业员工健康保险数据，发现该法案导致企业健康保险保费显著上升，企业通过增加兼职、临时工等非全职员工来减少保险覆盖人数，但企业绩效并未因此恶化。
This article discusses how mandating employers to provide health insurance of a minimum quality and the associated increases in health insurance premia affect firm employment and performance. Using firm-level employee health insurance data around the passage of the Patient Protection and Affordable Care Act (PPACA), we show that the PPACA is associated with a significant increase in health insurance premia for employees in company-sponsored health insurance plans. In response, employers with greater exposure to the PPACA reduce employee enrollments in their health insurance plans to a larger extent after the law’s enactment. Our analysis suggests that employers achieve this reduction in enrollment by shifting employment composition from full-time employees to part-time, temporary, or seasonal workers, who are not covered in employer-sponsored health insurance plans. Furthermore, we find no evidence of deterioration in performance at companies more exposed to the increase in health insurance premia. Overall, our findings illustrate how firms adapt to and mitigate cost increases associated with regulatory changes through strategic labor practices. This paper was accepted by Lin William Cong, finance. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2023.03761 .