The Affordable Care Act and Women’s Self-Employment in the United States

Abstract

The United States’ Affordable Care Act (ACA) of 2010 improved and expanded availability of non-group health insurance. Previous studies have shown that women in the US workforce value health insurance more highly than men do. Because prior to the ACA self-employed individuals did not have guaranteed access to affordable health insurance coverage, women’s relatively lower rate of self-employment may partly have reflected their greater “job lock” due to employer-based health insurance. This article employs nationally representative survey data for 2009–18 and a quasi-experimental difference-in-difference modeling approach and finds that unmarried women’s probability of self-employment increased by 1.2 percentage points in 2015–18, after the ACA’s expansion of non-group health insurance came into effect. Among women who have never married, overall probability of self-employment increased by 1.2–1.5 percentage points versus trend, and the probability of transitioning into full-time self-employment increased by 0.9 percentage points. HIGHLIGHTS In the US, unmarried women are less likely than men to be self-employed. The Affordable Care Act improved access to non-employer-based health insurance, reducing the cost of leaving jobs. As a result, from 2015–2018, unmarried women were increasingly drawn to self-employment. The ACA’s expansion of health insurance thus provides important economic benefits beyond healthcare access.