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The Impact of Macroeconomic Conditions on the Health Insurance Coverage of Americans

Author

Listed:
  • Cawley John

    (Cornell University and NBER)

  • Simon Kosali I.

    (Cornell University and NBER)

Abstract

In March 2001, the longest economic expansion in U.S. history ended, and an economic recession began. This paper seeks to provide a better understanding of the historical relationship between macroeconomic variables and health insurance coverage.We use data from two nationally representative samples: the Survey of Income and Program Participation (SIPP) and the National Longitudinal Survey of Youth (NLSY). The longitudinal nature of our data allows us to remove individual-specific, time-invariant heterogeneity and to focus on changes in health insurance status in response to changes in macroeconomic variables.The results confirm our prediction that the probability of any health insurance coverage is negatively associated with unemployment rate. We find that a one percentage point increase in the state unemployment rate is associated with a decrease in the probability of health insurance coverage, through any source, of 0.62 percent for men, 0.54 percent for women, and 1.1 percent for children. However, our prediction that an indicator variable for national recession would be negatively correlated with the probability of health insurance coverage is not supported by the data. We find that changes in employment status explain roughly one-quarter of the correlation between health insurance coverage and unemployment rates. Our estimates imply that 440,000 men, 436,000 women, and 494,000 children have lost health insurance coverage during the current recession.

Suggested Citation

  • Cawley John & Simon Kosali I., 2003. "The Impact of Macroeconomic Conditions on the Health Insurance Coverage of Americans," Forum for Health Economics & Policy, De Gruyter, vol. 6(1), pages 1-30, January.
  • Handle: RePEc:bpj:fhecpo:v:6:y:2003:n:5
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    References listed on IDEAS

    as
    1. Thomas S. Dee, 2001. "Alcohol abuse and economic conditions: Evidence from repeated cross-sections of individual-level data," Health Economics, John Wiley & Sons, Ltd., vol. 10(3), pages 257-270.
    2. Joyce, Theodore, 1990. "A time-series analysis of unemployment and health : The case of birth outcomes in New York city," Journal of Health Economics, Elsevier, vol. 8(4), pages 419-436, February.
    3. Gruber, Jonathan & Madrian, Brigitte C., 1997. "Employment separation and health insurance coverage," Journal of Public Economics, Elsevier, vol. 66(3), pages 349-382, December.
    4. David M. Cutler, 2003. "Employee Costs and the Decline in Health Insurance Coverage," NBER Chapters,in: Frontiers in Health Policy Research, Volume 6, pages 27-54 National Bureau of Economic Research, Inc.
    5. Ruhm, Christopher J. & Black, William E., 2002. "Does drinking really decrease in bad times?," Journal of Health Economics, Elsevier, vol. 21(4), pages 659-678, July.
    6. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, Oxford University Press, vol. 115(2), pages 617-650.
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    Cited by:

    1. Sherry Glied & Kathrine Jack, 2003. "Macroeconomic Conditions, Health Care Costs, and the Distribution of Health Insurance," NBER Working Papers 10029, National Bureau of Economic Research, Inc.
    2. Lo Sasso, Anthony T. & Buchmueller, Thomas C., 2004. "The effect of the state children's health insurance program on health insurance coverage," Journal of Health Economics, Elsevier, vol. 23(5), pages 1059-1082, September.
    3. Buchmueller Thomas C & Lo Sasso Anthony T & Wong Kathleen N, 2008. "How Did SCHIP Affect the Insurance Coverage of Immigrant Children?," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 8(2), pages 1-25, January.
    4. repec:dau:papers:123456789/7024 is not listed on IDEAS
    5. Sheila Hoag & Adam Swinburn & Sean Orzol & Michael Barna & Maggie Colby & Brenda Natzke & Christopher Trenholm & Fredric Blavin & Genevieve M. Kenney & Michale Huntress & Others, 2013. "CHIPRA Mandated Evaluation of Express Lane Eligibility: Final Findings," Mathematica Policy Research Reports 257e261f5ab440728eb301712, Mathematica Policy Research.
    6. Sheila Hoag & Sean Orzol & Margaret Colby & Adam Swinburn & Fredric Blavin & Genevieve M. Kenney & Michael Huntress, 2012. "CHIPRA Mandated Evaluation of Express Lane Eligibility First Year Findings," Mathematica Policy Research Reports ea8d230cec104e90ad417b32a, Mathematica Policy Research.
    7. Francis W. Ahking & Carmelo Giaccotto & Rexford E. Santerre, 2009. "The Aggregate Demand for Private Health Insurance Coverage in the United States," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 76(1), pages 133-157.
    8. repec:mpr:mprres:8009 is not listed on IDEAS

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