The Interaction of Disability, Labor Force Participation, and Health Care Coverage in the United States
The three papers in this session examine how variation in disability severity and labor force participation among the working-age disabled population can determine the type of coverage they receive. In the first paper, the authors use data from the Health and Retirement Study to compare employment and disability claims between newly-disabled individuals with employer-sponsored insurance (ESI) that have access to spousal coverage and those that do not. They find that access to spousal coverage does not affect employment or disability claims, but that ESI may influence labor attachment for those with high expected costs. The second paper looks at the disabled who may not have enough of an attachment to the labor force to obtain employer-sponsored benefits, yet are ineligible for public coverage due to earnings above income thresholds. After using the 1997-2011 National Health Interview Survey (NHIS) to document disparities in access to care between disabled workers and their peers, the authors predict how these disparities might be mitigated through the coverage expansions under the Affordable Care Act (ACA). Finally, the third paper characterizes the differences among the disabled, working-age adults enrolled in Medicaid, and who in this group is work-eligible for Medicare through Social Security Disability Insurance (SSDI). By using linked data between the 1999-2004 NHIS, the Centers for Medicare and Medicaid Services, and the Social Security Administration, the authors find significant differences between the work-eligible and ineligible in Medicaid, but find few differences between the work-eligible that transition into dual-eligibility and those that do not.