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

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Author Info
Thomas C. Buchmueller
John DiNardo

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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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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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Handle: RePEc:nbr:nberwo:8238

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Find related papers by JEL classification:
I1 - Health, Education, and Welfare - - Health
J3 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

  1. Ronald Oaxaca, . "Male-Female Wage Differentials in Urban Labor Markets," Working Papers 396, Princeton University, Department of Economics, Industrial Relations Section.. [Downloadable!]
    Other versions:
  2. 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. [Downloadable!]
  3. Farber, Henry S. & Levy, Helen, 2000. "Recent trends in employer-sponsored health insurance coverage: are bad jobs getting worse?," Journal of Health Economics, Elsevier, vol. 19(1), pages 93-119, January. [Downloadable!] (restricted)
  4. Fortin, Nicole M & Lemieux, Thomas, 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. [Downloadable!] (restricted)
  5. Janet Currie & Aaron S. Yelowitz, 1999. "Health Insurance and Less Skilled Workers," JCPR Working Papers 63, Northwestern University/University of Chicago Joint Center for Poverty Research.
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  6. Macpherson, David A., 1992. "Employer-provided retiree health insurance: Who is covered?," Economics Letters, Elsevier, vol. 39(1), pages 95-99, May. [Downloadable!] (restricted)
  7. Valletta, Robert G, 1999. "Declining Job Security," Journal of Labor Economics, University of Chicago Press, vol. 17(4), pages S170-97, October. [Downloadable!] (restricted)
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  8. Stephen A. Woodbury & Douglas R. Bettinger, 1989. "The decline of fringe-benefit coverage in the 1980s," Proceedings, Federal Reserve Bank of Cleveland, pages 105-143.
  9. Shulamit Kahn, 1990. "What Occupational Safety Tells Us about Political Power in Union Firms," RAND Journal of Economics, The RAND Corporation, vol. 21(3), pages 481-496, Autumn. [Downloadable!] (restricted)
  10. Richard B. Freeman, 1981. "The effect of unionism on fringe benefits," Industrial and Labor Relations Review, ILR Review, ILR School, Cornell University, vol. 34(4), pages 489-509, July.
  11. 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. [Downloadable!] (restricted)
  12. Hwang, Hae-shin & Reed, W Robert & Hubbard, Carlton, 1992. "Compensating Wage Differentials and Unobserved Productivity," Journal of Political Economy, University of Chicago Press, vol. 100(4), pages 835-58, August. [Downloadable!] (restricted)
  13. 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. [Downloadable!] (restricted)
  14. 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. [Downloadable!] (restricted)
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  1. Steven F. Lehrer & Nuno Sousa Pereira, 2008. "Worker Sorting, Health Insurance and Wages: Further Evidence from Displaced Workers in the United States," CETE Discussion Papers 0804, Universidade do Porto, Faculdade de Economia do Porto. [Downloadable!]
  2. Helen Levy, 2004. "Employer-Sponsored Disability Insurance: Where are the Gaps in Coverage?," NBER Working Papers 10382, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  3. 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. [Downloadable!]
  4. Jayanta Bhattacharya & William B. Vogt, 2006. "Employment and Adverse Selection in Health Insurance," NBER Working Papers 12430, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  5. 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. [Downloadable!]
  6. Steven F. Lehrer & Nuno Sousa Pereira, 2007. "Worker Sorting, Compensating Differentials and Health Insurance: Evidence from Displaced Workers," NBER Working Papers 12951, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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