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Union Effects on Health Insurance Provision and Coverage in the United States

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  • Thomas C. Buchmueller
  • John DiNardo

Abstract

During the past two decades, union density has declined in the United States and employer provision of health benefits has undergone substantial changes in extent and form. Using individual data spanning the years 1983-1997, combined with establishment data for 1993, we update and extend previous analyses of private-sector union effects on employer-provided health benefits. We find that the union effect on health insurance coverage rates has fallen somewhat but remains large, due to an increase over time in the union effect on employee 'take-up' of offered insurance, and that declining unionization explains 20-35 percent of the decline in employee health coverage. The increasing union take-up effect is linked to union effects on employees' direct costs for health insurance and the availability of retiree coverage.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 8238.

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Date of creation: Apr 2001
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Publication status: published as Thomas C. Buchmueller & John DiNardo & Robert G. Valletta, 2002. "Union effects on health insurance provision and coverage in the United States," Industrial and Labor Relations Review, ILR Review, ILR School, Cornell University, vol. 55(4), pages 610-627, July.
Handle: RePEc:nbr:nberwo:8238

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References

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  1. Janet Currie & Aaron Yelowitz, 1999. "Health Insurance and Less Skilled Workers," NBER Working Papers 7291, National Bureau of Economic Research, Inc.
  2. Shore-Sheppard, Lara & Buchmueller, Thomas C. & Jensen, Gail A., 2000. "Medicaid and crowding out of private insurance: a re-examination using firm level data," Journal of Health Economics, Elsevier, vol. 19(1), pages 61-91, January.
  3. Henry S. Farber & Helen Levy, 1998. "Recent Trends in Employer-Sponsored Health Insurance Coverage: Are Bad Jobs Getting Worse?," Working Papers 781, Princeton University, Department of Economics, Industrial Relations Section..
  4. Macpherson, David A., 1992. "Employer-provided retiree health insurance: Who is covered?," Economics Letters, Elsevier, vol. 39(1), pages 95-99, May.
  5. Gerald S. Goldstein & Mark V. Pauly, 1976. "Group Health Insurance as a Local Public Good," NBER Chapters, in: The Role of Health Insurance in the Health Services Sector, pages 73-114 National Bureau of Economic Research, Inc.
  6. Valletta, Robert G, 1999. "Declining Job Security," Journal of Labor Economics, University of Chicago Press, vol. 17(4), pages S170-97, October.
  7. Nicole M. Fortin & Thomas Lemieux, 1997. "Institutional Changes and Rising Wage Inequality: Is There a Linkage?," Journal of Economic Perspectives, American Economic Association, vol. 11(2), pages 75-96, Spring.
  8. Even, William E. & Macpherson, David A., 1991. "The impact of unionism on fringe benefit coverage," Economics Letters, Elsevier, vol. 36(1), pages 87-91, May.
  9. Bramley, Donald G. & Wunnava, Phanindra V. & Robinson, Michael D., 1989. "A note on union-non-union benefit differentials and size of establishment," Economics Letters, Elsevier, vol. 30(1), pages 85-88.
  10. Richard B. Freeman, 1981. "The effect of unionism on fringe benefits," Industrial and Labor Relations Review, ILR Review, Cornell University, ILR School, vol. 34(4), pages 489-509, July.
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Cited by:
  1. Buchmueller, Thomas C. & DiNardo, John & Valletta, Robert G., 2009. "The Effect of an Employer Health Insurance Mandate on Health Insurance Coverage and the Demand for Labor: Evidence from Hawaii," IZA Discussion Papers 4152, Institute for the Study of Labor (IZA).
  2. Helen Levy, 2004. "Employer-Sponsored Disability Insurance: Where are the Gaps in Coverage?," NBER Working Papers 10382, National Bureau of Economic Research, Inc.
  3. Lu, Yi & Tao, Zhigang & Wang, Yijiang, 2010. "Union effects on performance and employment relations: Evidence from China," China Economic Review, Elsevier, vol. 21(1), pages 202-210, March.
  4. Lehrer, Steven F. & Pereira, Nuno Sousa, 2007. "Worker sorting, compensating differentials and health insurance: Evidence from displaced workers," Journal of Health Economics, Elsevier, vol. 26(5), pages 1034-1056, September.
  5. Richard N. Block & Sheldon Friedman & Michelle Kaminski & Andy Levin (ed.), 2006. "Justice on the Job: Perspectives on the Erosion of Collective Bargaining in the United States," Books from Upjohn Press, W.E. Upjohn Institute for Employment Research, number joj.
  6. Jayanta Bhattacharya & William B. Vogt, 2006. "Employment and Adverse Selection in Health Insurance," NBER Working Papers 12430, National Bureau of Economic Research, Inc.
  7. Robert Hutchens & Patrick Nolen, 2006. "Will The Real Family-Friendly Employer Please Stand Up: Who Permits Parents To Reduce Working Hours For Purposes of Childcare?," Economics Discussion Papers 622, University of Essex, Department of Economics.
  8. David Zimmer, 2009. "Insurance Arrangements Among Married Couples: Analysis of Benefit Substitution and Compensating Differentials," Journal of Family and Economic Issues, Springer, vol. 30(4), pages 428-439, December.
  9. Jennifer Feenstra Schultz & David Doorn, 2009. "Employer Health Benefit Costs and Demand for Part-Time Labor," Working Papers 09-08, Center for Economic Studies, U.S. Census Bureau.
  10. Jaewhan Kim & Peter Philips, 2010. "Effect of Multiemployer Collective Bargaining on Employer-Provided Health Insurance in the Construction Industry," Journal of Labor Research, Springer, vol. 31(4), pages 322-331, December.
  11. Patricia H Born & Alice M Zawacki, 2003. "Manufacturing Firms' Decisions Regarding Retiree Health Insurance," Working Papers 03-14, Center for Economic Studies, U.S. Census Bureau.
  12. Lynn Blewett & Peter Graven & Jeanette Ziegenfuss & Michael Davern, 2009. "Trends in Employee Wage and Health Insurance Compensation for Employer-Sponsored Health Insurance (ESI) Coverage," Journal of Labor Research, Springer, vol. 30(4), pages 296-316, December.
  13. Alena Kimakova, 2010. "A Political Economy Model of Health Insurance Policy," Atlantic Economic Journal, International Atlantic Economic Society, vol. 38(1), pages 23-36, March.
  14. Alice Zawacki & Christine Eibner & Elaine Zimmerman, 2009. "Older Workers’ Access to Employer-Sponsored Retiree Health Insurance, 2000–2006," Journal of Labor Research, Springer, vol. 30(4), pages 350-364, December.

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