Three Papers on the Affordable Care Ac

This dissertation includes three separate studies examining various effects of the Affordable Care Act (ACA), which as signed into law by President Obama in 2010. The first two papers focus on the effect of the ACA Medicaid expansion, which went into effect in 2014, on hospital-level outcomes. The first analysis exploits the natural experiment provided by the ACA Medicaid expansion and provides strong evidence that the Medicaid expansion significantly reduced hospital level of uncompensated care. Building on these results, the second study uses an instrumental variables approach to examine the effect of the exogenous reduction in uncompensated care caused by the Medicaid expansion on hospital quality outcomes. The findings suggest an inverse relationship between uncompensated care and quality, with satisfactory patient experience scores decreasing as hospital level of uncompensated care rises. Also using a quasi-experimental research design, the third paper examines the effect of the ACA insurance expansions on the labor market behavior of older workers. The findings indicate that, despite concerns that the ACA might have the unintended effect of reducing labor supply, older workers did not alter their labor market behavior after the implementation of the insurance expansions in 2014, regardless of sector of employment.