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Employer-Sponsored Health Insurance and the Promise of Health Insurance Reform

  • Thomas C. Buchmueller
  • Alan C. Monheit

The central role that employers play in financing health care is a distinctive feature of the U.S. health care system, and the provision of health insurance through the workplace has important implications well beyond its role as source of health care financing. In this paper, we consider the "goodness of fit" of ESI in the current economic and health insurance environments and in light of prospects for a vigorous national debate over shape of health care reform. The main issue that we explore is whether ESI can have a viable role in health system reform efforts or whether such coverage will need to be significantly modified or even abandoned as reform seeks to address important issues in the efficient provision and equitable distribution of health insurance coverage, to create expanded health plan choices and competition in health insurance markets, and to structure incentives for the more efficient use of health services.

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File URL: http://www.nber.org/papers/w14839.pdf
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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 14839.

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Date of creation: Apr 2009
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Publication status: published as Employer-Sponsored Health Insurance and the Promise of Health Insurance Reform Thomas C. Buchmueller and Alan C. Monheit Inquiry Vol. 46, No. 2 (Summer 2009), pp. 187-202 Published by: Excellus Health Plan, Inc.
Handle: RePEc:nbr:nberwo:14839
Note: HC HE
Contact details of provider: Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.
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  2. Thomas M. Selden & Didem M. Bernard, 2004. "Tax Incidence and Net Benefits in the Market for Employment-Related Health Insurance: Sensitivity of Estimates to the Incidence of Employer Costs," International Journal of Health Care Finance and Economics, Springer, vol. 4(2), pages 167-192, 06.
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  6. 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).
  7. Summers, Lawrence H, 1989. "Some Simple Economics of Mandated Benefits," American Economic Review, American Economic Association, vol. 79(2), pages 177-83, May.
  8. Monheit, Alan C. & Steinberg Schone, Barbara, 2004. "How has small group market reform affected employee health insurance coverage?," Journal of Public Economics, Elsevier, vol. 88(1-2), pages 237-254, January.
  9. Thomas Buchmueller & John Dinardo, 2002. "Did Community Rating Induce an Adverse Selection Death Spiral? Evidence from New York, Pennsylvania, and Connecticut," American Economic Review, American Economic Association, vol. 92(1), pages 280-294, March.
  10. Ilayperuma Simon, Kosali, 2005. "Adverse selection in health insurance markets? Evidence from state small-group health insurance reforms," Journal of Public Economics, Elsevier, vol. 89(9-10), pages 1865-1877, September.
  11. Alan C. Monheit & Philip F. Cooper, 1994. "Health insurance and job mobility: Theory and evidence," Industrial and Labor Relations Review, ILR Review, Cornell University, ILR School, vol. 48(1), pages 68-85, October.
  12. Katherine Baicker & Amitabh Chandra, 2005. "The Labor Market Effects of Rising Health Insurance Premiums," NBER Working Papers 11160, National Bureau of Economic Research, Inc.
  13. Randall P. Ellis & Ching-to Albert Ma, 2005. "Health Insurance, Expectations, and Job Turnover," Boston University - Department of Economics - Working Papers Series WP2005-036, Boston University - Department of Economics.
  14. Thomasson, Melissa A., 2002. "From Sickness to Health: The Twentieth-Century Development of U.S. Health Insurance," Explorations in Economic History, Elsevier, vol. 39(3), pages 233-253, July.
  15. Jayanta Bhattacharya & William B. Vogt, 2006. "Employment and Adverse Selection in Health Insurance," NBER Working Papers 12430, National Bureau of Economic Research, Inc.
  16. Philip DeCicca, 2010. "Health Insurance Availability and Entrepreneurship," Upjohn Working Papers and Journal Articles 10-167, W.E. Upjohn Institute for Employment Research.
  17. Sharon K. Long & Karen Stockley & Alshadye Yemane, 2009. "Another Look at the Impacts of Health Reform in Massachusetts: Evidence Using New Data and a Stronger Model," American Economic Review, American Economic Association, vol. 99(2), pages 508-11, May.
  18. Brown, Charles & Medoff, James, 1989. "The Employer Size-Wage Effect," Journal of Political Economy, University of Chicago Press, vol. 97(5), pages 1027-59, October.
  19. Lo Sasso, Anthony T. & Lurie, Ithai Z., 2009. "Community rating and the market for private non-group health insurance," Journal of Public Economics, Elsevier, vol. 93(1-2), pages 264-279, February.
  20. Jonathan Gruber, 2008. "Covering the Uninsured in the U.S," NBER Working Papers 13758, National Bureau of Economic Research, Inc.
  21. Bradley Herring, 2010. "Suboptimal provision of preventive healthcare due to expected enrollee turnover among private insurers," Health Economics, John Wiley & Sons, Ltd., vol. 19(4), pages 438-448.
  22. 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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