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Disentangling the Complex Relationship Between Health, Health Insurance and Retirement
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Retirement is a major life event which involves changes in the identity, relationship, social status and life style for the retirees. It has a complex relationship with health and health insurance which has not been clearly understood. In this study, we dealt with three topics regarding retirement that are not thoroughly investigated in the current literature. In the first topic, we performed a systematic literature review on the relationship between employer-provided retiree health coverage and early retirement. Nine articles were included in the final analyses and all of them found a significant positive relationship. We also found strong evidence that retiree health coverage has a larger impact on early retirement at the ages of 60 to 64, and among women. In the second topic, we investigated the impact of Affordable Care Act (ACA) on retirement decisions among the near-elderly population. By using a difference-indifferences model, we compared the early retirement rates between respondents obtaining health coverage from health exchanges and Medicaid expansion, with the rest of the study sample. We found that ACA increased the probability of early retirement by around 15% in the former group. The results are robust to a number of robustness checks. In addition, we found the effect of ACA remains statistically significant when the study sample is restricted to the uninsured population, whose retirement incentives were believed not to be affected by ACA. In the third topic, we employed a fixed effect instrumental variable model to test the relationship between retirement and health, with a special focus on job characteristics. The results showed that retirement had an immediate preserving effect on self-rated health, ADLs, IADLs and mental health. This effect was accompanied by a significant adverse effect that accelerated health decline after retirement, which may finally undermine the immediate preserving effect with age. We found limited evidence that job characteristics were associated with health consequences of retirement.
Zhang, Hao (2019). Disentangling the Complex Relationship Between Health, Health Insurance and Retirement. Doctoral dissertation, Texas A&M University. Available electronically from