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Government Mandates and Employer-Sponsored Health Insurance: Who Is Still Not Covered?

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Abstract

We characterize employer-sponsored health insurance offering strategies in light of benefit non-discrimination and minimum wage regulation when workers have heterogeneous earnings and partially unobservable demand for (and cost of) insurance. We then empirically examine how earnings and expected medical expenses are associated with low wage workers' ability to obtain insurance before and after enactment of federal benefit non-discrimination rules. We find no evidence that the non-discrimination rules helped low wage workers (especially those with high own or children's expected medical expenses) to obtain insurance.

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References

  • Acs, G. (1995). “Explaining Trends in Health Insurance Coverage between 1988 and 1991.” Inquiry 32, 102–110.

    Google Scholar 

  • Branscome, J. M., P. F. Cooper, J. Sommers and J. P. Vistnes. (2000). “Private Employer-Sponsored Health Insurance: New Estimates by State.” Health Affairs 19, 139–147.

    Google Scholar 

  • Buchmueller, T. (1995). “Health Risk and Access to Employer-Provided Health Insurance.” Inquiry 32, 75–86.

    Google Scholar 

  • Buchmueller, T. and P. Feldstein. (1996). “Consumers' Sensitivity to Health Plan Premiums: Evidence from a Natural Experiment in California.” Health Affairs 15, 143–151.

    Google Scholar 

  • Cantor, J. C., S. H. Long and M. S. Marquis. (1995). “Private Employment-Based Health Insurance in Ten States.” Health Affairs 14, 199–211.

    Google Scholar 

  • Congressional Budget Office. (1991). Rising Health Care Costs: Causes, Implications and Strategies.Washington, DC: Government Printing Office.

    Google Scholar 

  • Cooper, P. and B. Schone. (1997). “More Offers, Fewer Takers for Employment-Based Health Insurance: 1987 and 1996.” Health Affairs 16, 142–149.

    Google Scholar 

  • Currie, J. and A. Yelowitz. (1999). Health Insurance and Less Skilled Workers. National Bureau of Economic Research Working Paper #7291.

  • Cutler, D. and S. Reber. (1998). “Paying for Health Insurance: The Tradeoff Between Competition and Adverse Selection.” Quarterly Journal of Economics 113, 433–466.

    Google Scholar 

  • Cutler, D. and R. Zeckhauser. (1997). Adverse Selection in Health Insurance. National Bureau of Economic Research Working Paper #6107.

  • Diamond, P. (1992). “Organizing the Health Insurance Market.” Econometrica 60, 1233–1254.

    Google Scholar 

  • Dranove, D., K. Spier and L. Baker. (2000). “Competition Among Employers Offering Health Insurance.” Journal of Health Economics 19, 121–140.

    Google Scholar 

  • Efron, B. (1987). “Better Bootstrap Confidence Intervals.” Journal of the American Statistical Association 82, 171–185.

    Google Scholar 

  • Farber, H. and H. Levy. (1998). Recent Trends in Employer-Sponsored Health Insurance Coverage: Are Bad Jobs Getting Worse? Princeton University Industrial Relations Section Working Paper #402.

  • Farley-Short, P. and T. Lair. (1994-1995). “Health Insurance and Health Status: Implications for Financing Health Care Reform.” Inquiry 31, 425–437.

    Google Scholar 

  • Friedman, B. (1974). “Risk Aversion and Consumer Choice of Health Insurance Options.” Review of Economics and Statistics 56, 209–214.

    Google Scholar 

  • Fronstin, P. and S. C. Snider. (1996). “An Examination of the Decline in Employment-Based Health Insurance between 1988 and 1993.” Inquiry 33, 317–325.

    Google Scholar 

  • Glied, S. and M. Stabile. (2000). “Explaining the Decline in Health Insurance Coverage Among Young Men.” Inquiry 37, 295–303.

    Google Scholar 

  • Goldberger, A. S. (1991). A Course in Econometrics. Boston: Harvard.

    Google Scholar 

  • Goldstein, G. S. and M. V. Pauly. (1976). “Group Health Insurance as a Local Public Good.” The Role of Health Insurance in the Health Services Sector. New York: National Bureau of Economic Research.

    Google Scholar 

  • Greene, W. H. (1999). Econometric Analysis, 4th ed. New Jersey: Prentice Hall.

    Google Scholar 

  • Gruber, J. (1994). “The Incidence of Mandated Maternity Benefits.” American Economic Review 84, 622–641.

    Google Scholar 

  • Gruber, J. and J. Poterba. (1995). Tax Subsidies to Employer-Provided Health Insurance. National Bureau of Economic Research Working Paper #5147.

  • Hardle, W. and O. Linton. (1994). “Applied Nonparametric Methods.” Handbook of Econometrics, Vol. IV. Amsterdam: Elsevier Science B.V.

    Google Scholar 

  • Heckman, J. J. (1979). “Sample Selection Bias as a Specification Error.” Econometrica 47, 153–162.

    Google Scholar 

  • Ketsche, P. G. andW. S. Custer. (2000). “The Effect of Marginal Tax Rate on the Probability of Employment-Based Insurance by Risk Group.” Health Services Research 35, 239–251.

    Google Scholar 

  • Kronick, R. (1991). “Health Insurance, 1979-1989: The Frayed Connection Between Employment and Insurance.” Inquiry 28, 318–332.

    Google Scholar 

  • Kronick, R. and T. Gilmer. (1999). “Explaining the Decline in Health Insurance Coverage: 1979-.” Health Affairs 18, 30–47.

    Google Scholar 

  • Levy, H. (1998). Who Pays for Health Insurance? Employee Contributions to Health Insurance Premiums. Princeton University Industrial Relations Section Working Paper #398.

  • Luft, H. (1986). “Compensating for Biased Selection in Health Insurance.” Milbank Quarterly 64, 566–591.

    Google Scholar 

  • Manning, W. G. and M. S. Marquis. (1996). “Health Insurance: The Tradeoff Between Risk Pooling and Moral Hazard.” Journal of Health Economics 15, 609–639.

    Google Scholar 

  • Manning, W. G., et al. (1987). “Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment.” American Economic Review 77, 251–277.

    Google Scholar 

  • Marquis, M. S. and M. R. Holmer. (1996). “Alternative Models of Choice under Uncertainty and Demand for Health Insurance.” Review of Economics and Statistics 78, 421–427.

    Google Scholar 

  • Mills, R. J. (2001). Health Insurance Coverage: 2000, U.S. Bureau of the Census, Current Population Reports, P60-215.

  • Morrisey, M. A., G. A. Jensen and R. J. Morlock. (1994). “Small Employers and the Health Insurance Market.” Health Affairs 13, 149–161.

    Google Scholar 

  • Mussa, M. and S. Rosen. (1978). “Monopoly and Product Quality.” Journal of Economic Theory 18, 301–317.

    Google Scholar 

  • Nyman, J. A. (1999). “The Value of Health Insurance: The Access Motive.” Journal of Health Economics 18, 141–152.

    Google Scholar 

  • Pauly, M. V. (1997). Health Benefits At Work, An Economic and Political Analysis of Employment-Based Health Insurance. Ann Arbor: University of Michigan Press.

    Google Scholar 

  • Rhine, S. L. and Y. C. Ng. (1998). “The Effect of Employment Status on Private Health Insurance Coverage: 1977 and 1987.” Health Economics 7, 63–79.

    Google Scholar 

  • Rosen, S. (1974). “Hedonic Prices and Implicit Markets: Product Differentiation in Pure Competition.” Journal of Political Economy 82, 34–55.

    Google Scholar 

  • Rothschild, M. and J. Stiglitz. (1976). “Equilibrium in Competitive Insurance Markets: An Essay on the Economics of Imperfect Information.” Quarterly Journal of Economics 90, 629–649.

    Google Scholar 

  • Scott, F., M. Berger and J. Garen. (1995). “Do Health Insurance and Pension Costs Reduce the Job Opportunities of Older Workers?” Industrial and Labor Relations Review 48, 775–791.

    Google Scholar 

  • Sheils, J. and P. Hogan. (1999). “Cost of Tax-Exempt Health Benefits in 1998.” Health Affairs 18, 176–181.

    Google Scholar 

  • Silverman, B. W. (1986). Density Estimation for Statistics and Data Analysis. London: Chapman and Hall.

    Google Scholar 

  • Summers, L. H. (1989). “Some Simple Economics of Mandated Benefits.” American Economic Review (Papers and Proceedings) 79, 177–183.

    Google Scholar 

  • Thorpe, K. (1992). “Expanding Employment-Based Health Insurance: Is Small Group Reform the Answer?” Inquiry 29, 128–136.

    Google Scholar 

  • U.S. Department of Commerce. (1993). “Estimates of Employer Contributions for Group Health Insurance by Industry and Preliminary Baseline Projections for theYear 2000.” Unpublished Memorandum from Paul London, Acting Under Secretary for Economic Affairs to Joseph Stiglitz, Member, Council of Economic Advisers.

  • U.S. Dept. of Labor. (2001). “Employer Costs for Employee Compensation-March 2001.” News Resease, U.S. Department of Labor, USDL 01-194.

  • Vanness, D. J. (2000). Choice, Information and Quality of Employer-Sponsored Health Insurance. Ph.D. Thesis, University of Wisconsin-Madison.

  • Wolfe, B. L., A. Wolaver and T. McBride. (1998). “Government Mandates, Health Insurance and the Deterioration of the Low-Wage Labor Market: Are They Connected?” The State of Social Welfare. Aldershot: Ashgate, 143–190.

    Google Scholar 

  • Woodbury, S. H. (1983). “Substitution Between Wage and Nonwage Benefits.” American Economic Review 73, 166–182.

    Google Scholar 

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Vanness, D.J., Wolfe, B.L. Government Mandates and Employer-Sponsored Health Insurance: Who Is Still Not Covered?. International Journal of Health Care Finance and Economics 2, 99–135 (2002). https://doi.org/10.1023/A:1019926515031

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