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Papers Containing Keywords(s): 'insurance employer'

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  • Working Paper

    How Do Health Insurance Costs Affect Firm Labor Composition and Technology Investment?

    September 2023

    Working Paper Number:

    CES-23-47

    Employer-sponsored health insurance is a significant component of labor costs. We examine the causal effect of health insurance premiums on firms' employment, both in terms of quantity and composition, and their technology investment decisions. To address endogeneity concerns, we instrument for insurance premiums using idiosyncratic variation in insurers' recent losses, which is plausibly exogenous to their customers who are employers. Using Census microdata, we show that following an increase in premiums, firms reduce employment. Relative to higher-income coworkers, lower-income workers see a larger increase in their likelihood of being separated from their jobs and becoming unemployed. Firms also invest more in information technology, potentially to substitute labor.
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  • Working Paper

    The Underserved Have Less Access to Employer-Sponsored Telemedicine Coverage

    September 2022

    Working Paper Number:

    CES-22-40

    Telemedicine has been proposed as one means of improving health care access for underserved communities, and information about insurance coverage for telemedicine (TMC) is important in understanding its utilization and provision. We use 2018-2019 Medical Expenditure Panel Survey-Insurance Component data on employer-sponsored coverage to examine pre-pandemic TMC relative to employer, worker, and health plan characteristics. We find that the share of employees in private sector establishments offering TMC was lower in the most rural counties, in smaller firms, in establishments without unionized employees, and in establishments where most workers were low wage, part-time and older when compared to other establishments. These findings reflect differences across establishments in insurance offers, as well as differences in TMC conditional on an insurance offer, which suggests that TMC may function as a premium plan feature with limited availability and potential support for improving healthcare access for the underserved.
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  • Working Paper

    HOW WILL THE AFFORDABLE CARE ACT CHANGE EMPLOYERS' INCENTIVES TO OFFER INSURANCE?

    January 2014

    Working Paper Number:

    CES-14-02

    This study investigates how changes in the economic incentives created by the Affordable Care Act (ACA) will affect the probability that private-sector U.S. employers will offer health insurance. Using the Medical Expenditure Panel Survey Insurance Component for 2008-2010, we predict employers' responses to key ACA provisions. Our simulations predict that overall demand for insurance will rise, driven by workers' desire to avoid the individual mandate penalty and the availability of premium tax credits in exchanges. Our analyses also suggest that the average probability of an establishment offering insurance will decline from .83 to .66 with ACA implementation, although there is considerable variation by firm size, industry and union status.
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  • Working Paper

    NEW EVIDENCE ON EMPLOYER PRICE-SENSITIVITY OF OFFERING HEALTH INSURANCE

    January 2014

    Working Paper Number:

    CES-14-01

    Economic incentives such as the preferential tax treatment of premiums and economies of scale encourage employers to provide health insurance through the workplace. The employer's decision to offer health insurance depends on how much workers value insurance relative to wages, and that value is likely to vary, given the composition of the establishment's workforce. Using the 2008-2010 MEPS Insurance Component augmented with information from other data sources, we generate new estimates of employers' price-sensitivity of offering insurance. Our results suggest that employers are sensitive to changes in the tax price of insurance, with very small employers exhibiting the largest price-sensitivity. Employer size, workforce composition, and local labor market conditions also influence the employer's decision to offer insurance. New evidence can inform policy discussions about the implications of broad-based reforms that change marginal tax rates as well as targeted strategies that address the tax-exempt status of premiums.
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  • Working Paper

    COMPARING METHODS FOR IMPUTING EMPLOYER HEALTH INSURANCE CONTRIBUTIONS IN THE CURRENT POPULATION SURVEY

    August 2013

    Working Paper Number:

    CES-13-41

    The degree to which firms contribute to the payment of workers' health insurance premiums is an important consideration in the measurement of income and for understanding the potential impact of the 2010 Affordable Care Act on employment-based health insurance participation. Currently the U.S. Census Bureau imputes employer contributions in the Annual Social and Economic Supplement of the Current Population Survey based on data from the 1977 National Medical Care Expenditure Survey. The goal of this paper is to assess the extent to which this imputation methodology produces estimates reflective of the current distribution of employer contributions. The paper uses recent contributions data from the Medical Expenditure Panel Survey-Insurance Component to estimate a new model to inform the imputation procedure and to compare the resulting distribution of contributions. These new estimates are compared with those produced under current production methods across employee and employer characteristics.
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  • Working Paper

    Long-Run Earnings Volatility and Health Insurance Coverage: Evidence from the SIPP Gold Standard File

    October 2011

    Authors: Matthew Rutledge

    Working Paper Number:

    CES-11-35

    Despite the notable increase in earnings volatility and the attention paid to the growing ranks of the uninsured, the relationship between career earnings and short- and mediumrun health insurance status has been ignored due to a lack of data. I use a new dataset, the SIPP Gold Standard File, that merges health insurance status and demographics from the Survey of Income and Program Participation with career earnings records from the Social Security Administration (SSA) and the Internal Revenue Service (IRS) to examine the relationship between long-run family earnings volatility and health insurance coverage. I find that more volatile career earnings are associated with an increased probability of experiencing an uninsured episode, with larger effects for men, young workers, and the unmarried. These findings are consistent with the 'scarring' literature, and suggest the importance of safety-net measures for job losses and health insurance coverage.
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  • Working Paper

    Health Insurance and Productivity: Evidence from the Manufacturing Sector

    September 2009

    Working Paper Number:

    CES-09-27

    This paper examines the relationship between employer-sponsored offers of health insurance and establishments' labor productivity. Our empirical work is based on unique plant level data that links the 1997 and 2002 Medical Expenditure Panel Survey-Insurance Component with the 1992, 1997, and 2002 Census of Manufactures. These linked data provide information on employer-provided insurance and productivity. We find that health insurance offers are positively associated with levels of establishments' labor productivity. These findings hold for all manufacturers as well as those with fewer than 100 employees. Our preliminary results also show a drop in health care costs from the 75th to the 25th percentile would increase the probability of a plant offering insurance by 1.5-2.0 percent in both 1997 and 2002. The results from this paper provide encouraging and new empirical evidence on the benefits employers may reap by offering health insurance to workers.
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  • Working Paper

    Employer Health Benefit Costs and Demand for Part-Time Labor

    April 2009

    Working Paper Number:

    CES-09-08

    The link between rising employer costs for health insurance benefits and demand for part-time workers is investigated using non-public data from the Medical Expenditure Panel Survey- Insurance Component (MEPS-IC). The MEPS-IC is a nationally representative, annual establishment survey from the Agency for Healthcare Research and Quality (AHRQ). Pooling the establishment level data from the MEPS-IC from 1996-2004 and matching with the Longitudinal Business Database and supplemental economic data from the Bureau of Labor Statistics, a reduced form model of the percent of total FTE employees working part-time is estimated. This is modeled as a function of the employer health insurance contribution, establishment characteristics, and state-level economic indicators. To account for potential endogeneity, health insurance expenditures are estimated using instrumental variables (IVs). The unit of analysis is establishments that offer health insurance to full-time employees but not part time employees. Conditional on establishments offering health insurance to full-time employees, a 1 percent increase in employer health insurance contributions results in a 3.7 percent increase in part-time employees working at establishments in the U.S.
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  • Working Paper

    Using the MEPS-IC to Study Retiree Health Insurance

    April 2006

    Authors: Alice Zawacki

    Working Paper Number:

    CES-06-13

    This paper discusses using the restricted-access Medical Expenditure Panel Survey- Insurance Component (MEPS-IC) to study employer-sponsored retiree health insurance (RHI). This topic is particularly interesting given current events such as the aging of baby boomers, rising health care costs, new prescription drug coverage under Medicare, and changes in accounting standards for reporting liabilities related to RHI offerings. Consequently, employers are grappling with an aging workforce, evaluating Medicare subsidies to employers for offering retiree drug plans, facing rising premium costs as a result of rising health care costs, and trying to show profitability on financial reports. This paper provides technical information on using the MEPS-IC to study RHI and points out data issues with some of the measures in the database. Descriptive statistics are provided to illustrate the types of retiree estimates possible using the MEPS-IC and to show some of the trends in this subject area. Not surprising, these estimates show that employer offers of RHI have declined, greater numbers of retirees are enrolling in these plans, and expenditures for employer-sponsored RHI have been rising.
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  • Working Paper

    Estimating the Relationship between Employer-Provided Health Insurance, Worker Mobility, and Wages

    September 2002

    Authors: Martha Stinson

    Working Paper Number:

    tp-2002-23

    In this paper, a joint model of wages, hazard of a job ending, and probability of holding employer-provided health insurance is estimated, taking account of unobservable person and job characteristics. A unique data source, the 1990 and 1996 SIPP Panels linked to SSA administrative job histories, enables the identification of random person and job effects and the correlation of these effects across the three equations. The explicit modeling of this correlation produces consistent estimates of the effect of tenure on wages and the effect of health insurance on mobility. Substantial levels of job-lock and significant annual returns to seniority are found. Increasing the job-specific probability of obtaining employerprovided health insurance from 60% to 63%, or increasing the job-specific hourly wage rate by $.80, are both associated with an equivalent decrease in the hazard of the job ending. However, the dollar value of the wage benefit is substantially higher.
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