Medicaid-ing Health Insurance Coverage for Displaced Workers: Evidence from Virginia
(Revised August 3, 2026)
Most Americans obtain health insurance through their employer, making job loss a leading cause of coverage gaps. Using novel administrative tax data covering 1.6 million displaced workers, we provide the first causal estimates of how the ACA’s Medicaid expansion affected coverage volatility after job loss. Leveraging Virginia’s 2019 expansion, we find a 190% increase in Medicaid take-up among displaced workers, a 10% reduction in uninsurance duration for all workers, and a 3.6-month reduction for those who enrolled. Effects are largest for the lowest earners. The expansion also reduced take-up of private marketplace coverage, partially offsetting coverage gains.
