Decline In Health Insurance Coverage Research Articles

Decline in health insurance coverage in US has halted

Decline in health insurance coverage in US has halted

Employer-Sponsored Health Insurance Coverage Continues to Decline in a New Decade

Most Americans, particularly those under age 65, rely on health insurance offered through the workplace. Given continuing high unemployment, it comes as no surprise that the share of Americans under age 65 covered by employer-sponsored health insurance (ESI) eroded for the 11th year in a row in 2011, falling from 58.6 percent in 2010 to 58.3 percent. The situation started deteriorating long before the Great Recession: the share of Americans under age 65 covered by ESI eroded every year from 2000 to 2011, decreasing by a total of 10.9 percentage points. As many as 29 million more people under age 65 would have had ESI in 2011 if the coverage rate had remained at the 2000 level. The decline in ESI coverage has been accompanied by an overall decline in health insurance coverage. The number of uninsured non-elderly Americans was 47.9 million in 2011--11.7 million higher than in 2000. Increasing public insurance coverage, particularly among children, is the only reason the uninsured rate did not rise one-for-one with losses in ESI. In addition, key components in the Patient Protection and Affordable Care Act took effect in 2010, shielding young adults from further coverage losses.

Experimental Republic: Medical Accidents (Productive and Unproductive) in Postsocialist China

Medical accidents have become an unexpected source of political friction in reform-era China, leading in certain, well-publicized cases to mass riots and violent attacks against hospital staff. This article situates the problem of the medical accident alongside the wider politicization of risk in postsocialist China, arguing that the single act of medical negligence must be understood as symptomatic of the general decline in health insurance coverage during the past three decades. The article considers two institutional responses to the problem of the medical accidents that have been deployed under the aegis of Hu Jintao's “Harmonious Society”: on the one hand, the government has sought to juridify risks by introducing a comprehensive statute on tort law, and on the other, the unproductive risks engendered by the inadequacies of health insurance have been transformed into potentially productive risks through the introduction of multinational clinical trials into the large urban hospitals. The article concludes with a reflection on the political limits of risk mediation in the Harmonious Society.

Declining health insurance access among US hispanic workers: Not all jobs are created equal

Approximately 18% of the U.S. population are uninsured, a proportion that may continue to rise, particularly among Hispanics, as the cost of medical care increases faster than the growth in wages. Health insurance trends were analyzed by race-ethnic category, and among Hispanic workers by occupation type and industrial sector, using data on employed respondents > or =18 years from 1997 to 2007 National Health Interview Survey (NHIS) (mean annual n = 17,392, representing 123 million US workers on average over this 11 year period). From 1997 to 2007, the relative decline in health insurance coverage for US workers was greatest among Hispanics (7.0%). Hispanic workers in the Construction and Services industries had the greatest overall decline in coverage (24.9% and 14.7%), as well as Hispanic blue collar workers (14.0%). Hispanic workers in general, and those employed in blue collar, construction, and services sectors in particular, are at greater risk for poor access to health care due to a lack of health insurance coverage.

The Erosion of Employment-Based Insurance: More Working Families Left Uninsured

The number of Americans without health insurance rose from 38.4 million in 2000 to 47.0 million in 2006, primarily due to the precipitous decline in employer-provided health coverage for workers and their families. Nearly 3.9 million fewer Americans under 65 had employer-provided coverage in 2006 than in 2000. The downward trend in the rate of employer-provided insurance continued for the sixth year in a row, falling from 68.3 to 62.9 percent. Individuals among the bottom 20 percent of household income were the least likely to have employer coverage. Jobholders experienced a significant decline in health insurance coverage, from 74.8 percent of workers in 2000 to 70.8 percent in 2006. No category of workers was insulated from loss of coverage. Children experienced declines in employer-provided health insurance coverage (through their parents) in each of the past five years, the rate falling from 65.9 percent of children in 2000 to 59.7 percent in 2006. Public health insurance (Medicaid and the State Children's Health Insurance Program) is no longer offsetting these losses. The decline in employer-provided coverage was felt throughout the country. Between the 2000-2001 and 2005-2006 periods, 38 states experienced significant losses in employment-based coverage for the under-65 population. No state experienced a significant increase in the coverage rate.

Welfare reform and the decline in the health-insurance coverage of children of non-permanent residents

The 1996 Welfare Reform Act tightened public health-insurance coverage restrictions for non-permanent residents (NPRs) and altered the eligibility of newly permanent residents (PRs). By drawing on data from the SIPP, this paper explores to what extent welfare reform led to a decline in health-insurance coverage for children of NPRs. This paper proposes that the proportion of uninsured children of NPRs with low social economic status (SES) increased by approximately 10 percentage points relative to their PR counterparts. Furthermore, although eligible for Medicaid, citizen children of NPRs of low SES lost approximately 17 percentage points in coverage.

It's The Premiums, Stupid: Projections Of The Uninsured Through 2013

Increases in the cost of health care from 1979 to 1999 accounted for the decline in health insurance coverage that occurred during that time period, as our earlier work demonstrated. Here we examine whether the model we presented adequately accounts for the observed changes in health insurance coverage from 1999 through 2002, and we show that the model accurately predicted the increase in uninsured people during that time period. Using the model and projections for national health spending, we project that the number of nonelderly uninsured Americans will grow from forty-five million in 2003 to fifty-six million by 2013.

Fringe Benefits and Inequality in the Labor Market

This study shows that when fringe benefits are accounted for, inequality increases at a point in time and grew faster from 1987 to 1994. Several alternative explanations of the observed discrepancies between wage inequality and compensation inequality are assessed. The evidence is that the disproportionately greater decline in income for less skilled workers is responsible for the greater decline in health insurance coverage, which in turn contributes to greater inequality growth when fringe benefits are accounted for.

Price and Spouse's Coverage in Employee Demand for Health Insurance

The decline in health insurance coverage over the last two decades is a matter of national concern. The vast majority of insured individuals under age 65 obtain this coverage from their employer or as a dependent of a family member with group-sponsored health insurance. Recent evidence suggests that the decrease in coverage among full-time workers has resulted not so much from declining employer offers but rather from reduced take-up. The reasons for this change in employee behavior are not yet understood. Resolving this question is important for public policy because the two most likely explanations - the rise in employee insurance premiums and the increase in spousal coverage over this period - have different policy implications. We pool data from five supplements to the Current Population Survey covering the period 1988-2001 to examine the roles of insurance price and spousal coverage in decisions to elect employer-based coverage. We estimate the demand for employer-based health insurance among eligible workers as a function of price (measured as employee's share of total premium costs), firm size, employee characteristics, labor force status of spouses and, among working spouses, coverage under own employer plans. We find that the decisions of eligible full-time wage and salaried married workers to elect coverage are significantly influenced both by the costs of their own plans and by whether their spouses are covered under their own employment-based plans. We also find that women are considerably more responsive than men to both cost and spouses' coverage. Our findings provide the first evidence that price matters in the take-up decisions of full-time married workers, and that part of the decline in take-up in recent years may be attributed to the increasing cost of insurance. This decline is also explained, however, by the increase in the proportion of full-time workers whose spouses are covered under their own employer plans. Whether this latter trend is itself an outcome of rising insurance price remains to be determined.

Price and Spouse’s Coverage in Employee Demand for Health Insurance.

The decline in health insurance coverage over the last two decades is a matter of national concern. The vast majority of insured individuals under age 65 obtain coverage from their employer or as dependents of a family member with group-sponsored health insurance. Recent evidence suggests that the decrease in coverage among full-time workers has resulted not so much from declining employer offers but rather from reduced take-up (Henry S. Farber and Helen Levy, 2000). The reasons for this change in employee behavior are not yet understood. Resolving this question is important for public policy because the two most likely explanations (the rise in employee insurance premiums and the increase in coverage of spouses under their own plans over this period) have different policy implications. Table 1 shows these trends by gender for full-time married workers from 1988 to 2001. The proportion of workers paying part or all of total insurance premiums increased nearly 20 percent, and the proportion with spouses covered under their own employer plans increased 30 percent among women and doubled among men. Table 1 also confirms that, while offer and eligibility rates declined somewhat for full-time workers over this period, take-up rates fell substantially among eligible workers. Concern among policymakers has focused on whether rising employee costs have forced workers to opt out of offered coverage. In this case, the number of uncovered individuals and

Employee Costs and the Decline in Health Insurance Coverage

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.

Small employers and their health benefits, 1988-1996: an awkward adolescence.

Limited choice and high out-of-pocket costs for employees in small firms may help to explain the managed care backlash.