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Employee Costs and the Decline in Health Insurance Coverage

Author

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  • Cutler David M.

    (Harvard University and NBER)

Abstract

This paper examines why health insurance coverage fell despite the lengthy economic boom of the 1990s. I show that insurance coverage declined primarily because fewer workers took up coverage when offered it, not because fewer workers were offered insurance or were eligible for it. The reduction in take-up is associated with the increase in employee costs for health insurance. Estimates suggest that increased costs to employees can explain the entire decline in take-up rates in the 1990s.

Suggested Citation

  • Cutler David M., 2003. "Employee Costs and the Decline in Health Insurance Coverage," Forum for Health Economics & Policy, De Gruyter, vol. 6(1), pages 1-29, January.
    • Handle: RePEc:bpj:fhecpo:v:6:y:2003:n:3
    DOI: 10.2202/1558-9544.1045
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    Citations

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    Cited by:

    1. Schmitz, Hendrik & Ziebarth, Nicolas R., 2011. "In Absolute or Relative Terms? How Framing Prices Affects the Consumer Price Sensitivity of Health Plan Choice," IZA Discussion Papers 6241, Institute of Labor Economics (IZA).
    2. Hendrik Schmitz & Nicolas R. Ziebarth, 2011. "In Absolute or Relative Terms? How Framing Prices Affects the Consumer Price Sensitivity of," Ruhr Economic Papers 0304, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    3. Krueger, Alan B. & Kuziemko, Ilyana, 2013. "The demand for health insurance among uninsured Americans: Results of a survey experiment and implications for policy," Journal of Health Economics, Elsevier, vol. 32(5), pages 780-793.
    4. Holland, Sara B., 2017. "Firm investment in human health capital," Journal of Corporate Finance, Elsevier, vol. 46(C), pages 374-390.
    5. Tracy L. Regan & Gulcin Gumus, 2006. "Tax Incentives as a Solution to the Uninsured: Evidence from the Self-Employed," Working Papers 0709, University of Miami, Department of Economics, revised Oct 2007.
    6. Hashem Abdullah AlNemer, 2018. "Perception of the Benefits and Features of Health Insurance Policies Offered by the Employers: Empirical Findings from Saudi Arabia," International Journal of Business and Management, Canadian Center of Science and Education, vol. 13(6), pages 214-214, April.
    7. Buchmueller, Thomas, 2006. "Price and the health plan choices of retirees," Journal of Health Economics, Elsevier, vol. 25(1), pages 81-101, January.
    8. Ines Läufer, 2014. "Das Krankenversicherungssystem in den USA: Bestimmungsparameter des Angebots und der Ausgestaltungformen von Arbeitgeber-Gruppenversicherungen," Otto-Wolff-Institut Discussion Paper Series 03/2014, Otto-Wolff-Institut für Wirtschaftsordnung, Köln, Deutschland.
    9. Otto Lenhart, 2020. "Pathways Between Minimum Wages and Health: The Roles of Health Insurance, Health Care Access and Health Care Utilization," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 46(3), pages 438-459, June.
    10. repec:pri:cepsud:217krueger is not listed on IDEAS
    11. Thomas M. Selden, 2009. "The Impact of Increased Tax Subsidies on the Insurance Coverage of Self-Employed Families: Evidence from the 1996–2004 Medical Expenditure Panel Survey," Journal of Human Resources, University of Wisconsin Press, vol. 44(1).
    12. Monheit, Alan C. & Vistnes, Jessica Primoff, 2005. "The demand for dependent health insurance: How important is the cost of family coverage?," Journal of Health Economics, Elsevier, vol. 24(6), pages 1108-1131, November.
    13. Dragone, Davide & Ziebarth, Nicolas R., 2015. "Economic Development, Novelty Consumption, and Body Weight: Evidence from the East German Transition to Capitalism," IZA Discussion Papers 8967, Institute of Labor Economics (IZA).
    14. Vasilios Kosteas & Francesco Renna, 2009. "The Impact of Job Displacement on Employer Based Health Insurance Coverage," Journal of Labor Research, Springer, vol. 30(4), pages 317-327, December.
    15. repec:zbw:rwirep:0304 is not listed on IDEAS
    16. Krueger, Alan B. & Kuziemko, Ilyana, 2013. "The demand for health insurance among uninsured Americans: Results of a survey experiment and implications for policy," Journal of Health Economics, Elsevier, vol. 32(5), pages 780-793.
    17. Richard V. Burkhauser & Kosali I. Simon, 2008. "Who Gets What From Employer Pay or Play Mandates?," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 11(1), pages 75-102, March.
    18. repec:pri:indrel:dsp01bc386j227 is not listed on IDEAS
    19. Kosteas, Vasilios D. & Renna, Francesco, 2014. "Plan choice, health insurance cost and premium sharing," Journal of Health Economics, Elsevier, vol. 35(C), pages 179-188.
    20. David Zimmer, 2010. "Health Insurance and Health Care Demand Among the Self-employed," Journal of Labor Research, Springer, vol. 31(1), pages 1-19, March.
    21. Vasilios D. Kosteas & Francesco Renna, 2018. "Out of Pocket Costs and Health Insurance Take-Up Rates," Applied Health Economics and Health Policy, Springer, vol. 16(3), pages 367-380, June.
    22. Jessica Vistnes & Alice Zawacki & Kosali Simon & Amy Taylor, 2010. "Declines in Employer Sponsored Coverage Between 2000 and 2008: Offers, Take-Up, Premium Contributions, and Dependent Options," Working Papers 10-23, Center for Economic Studies, U.S. Census Bureau.
    23. Marjorie A. Rosenberg & Paul H. Johnson, Jr. & Ian G. Duncan, 2010. "Perspectives Articles: Exploring Stakeholder Perspectives on What Is Affordable Health Care," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 13(2), pages 251-263, September.
    24. Otto Lenhart, 2019. "The effects of income on health: new evidence from the Earned Income Tax Credit," Review of Economics of the Household, Springer, vol. 17(2), pages 377-410, June.

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