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Declines in Employer Sponsored Coverage Between 2000 and 2008: Offers, Take-Up, Premium Contributions, and Dependent Options

Listed author(s):
  • Jessica Vistnes
  • Alice Zawacki
  • Kosali Simon
  • Amy Taylor

Even before the current economic downturn, rates of employer-sponsored insurance (ESI) declined substantially, falling six percentage points between 2000 and 2008 for nonelderly Americans. During a previously documented decline in ESI, from 1987 to 1996, the fall was found to be the result of a reduction in enrollment or ‘take-up’ of offered coverage and not a decline in employer offer/eligibility rates. In this paper, we investigate the components of the more recent decline in ESI coverage by firm size, using data from the MEPS-IC, a large nationally representative survey of employers. We examine changes in offer rates, eligibility rates and take-up rates for coverage, and include a new dimension, the availability of and enrollment in dependent coverage. We investigate how these components changed for employers of different sizes and find that declining coverage rates for small firms were due to declines in both offer and take-up rates while declining rates for large firms were due to declining enrollment in offered coverage. We also find a decrease in the availability of dependent coverage at small employers and a shift towards single coverage across employers of all sizes. Understanding the components of the decline in coverage for small and large firms is important for establishing the baseline for observing the effects of the current economic downturn and the implementation of health insurance reform.

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Paper provided by Center for Economic Studies, U.S. Census Bureau in its series Working Papers with number 10-23.

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Length: 25 pages
Date of creation: Sep 2010
Handle: RePEc:cen:wpaper:10-23
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  1. 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.
  2. 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.
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