Employment-based health insurance for children: Why did coverage increase in the mid-1990s?

Health Affairs

Volumn 18, Issue 5, 1999, Pages 131-136

  Fronstin, Paul ^a  

^a Employee Benefit Research Institute   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ARTICLE; CHILD; CHILD HEALTH CARE; COST BENEFIT ANALYSIS; ECONOMICS; FEMALE; FORECASTING; HEALTH INSURANCE; HUMAN; INFANT; INSURANCE; MALE; NEWBORN; PATIENT; PRESCHOOL CHILD; STATISTICS; UNITED STATES;

ADOLESCENT; CHILD; CHILD HEALTH SERVICES; CHILD, PRESCHOOL; COST-BENEFIT ANALYSIS; FEMALE; FORECASTING; HEALTH BENEFIT PLANS, EMPLOYEE; HUMANS; INFANT; INFANT, NEWBORN; INSURANCE COVERAGE; MALE; MEDICALLY UNINSURED; UNITED STATES;

EID: 0033194736     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.18.5.131     Document Type: Article

References (13)

1. The increase in coverage is significant at the 1 percent level. These data points are slightly lower than those published by the Census Bureau. The difference stems from how private insurance is treated when it is obtained from someone outside the household. The Census Bureau treats private insurance obtained from out-side the household as employment-based coverage. In contrast, this paper does not treat insurance received from someone outside the household as employment-based coverage because there is no way to confirm that the source of coverage is related to employment.
2. Whether or not a person has insurance coverage is part of a larger dynamic process composed of some people getting coverage who did not previously have it, and other people losing coverage. Because the results in this paper did not follow the same people between 1994 and 1997, the 1.8 million increase in the number of children with coverage studied here represents a net increase. This increase includes both children who both have gained employment-based coverage and those who lost such coverage.
3. J. Gabel et al., "Health Benefits of Small Employers in 1998" (Report prepared for the Henry J. Kaiser Family Foundation, February 1999).
4. While the March CPS has undergone changes to the questionnaire over the years, the last change occurred in March 1995. As a result, the data presented in this paper are comparable.
5. K. Short, "Health Insurance Coverage: 1987-1990," Current Population Reports, Series P-70, no. 29 (Washington: U.S. Department of Commerce, Bureau of the Census, 1992); and K. Swartz, "Interpreting Estimates from Four National Surveys of the Number of People without Health Insurance," Journal of Economic and Social Measurement 14, no. 3 (1986): 233-242. For an ex-cellent discussion of the health insurance data issues in various data sets, see K. Lewis, M. Ellwood, and J.L Czajka, "Counting the Uninsured: A Review of the Literature," Occasional Paper no. 8 (Washington: Urban Institute, July 1998).
6. K. Short, "Health Insurance Coverage: 1987-1990," Current Population Reports, Series P-70, no. 29 (Washington: U.S. Department of Commerce, Bureau of the Census, 1992); and K. Swartz, "Interpreting Estimates from Four National Surveys of the Number of People without Health Insurance," Journal of Economic and Social Measurement 14, no. 3 (1986): 233-242. For an ex-cellent discussion of the health insurance data issues in various data sets, see K. Lewis, M. Ellwood, and J.L Czajka, "Counting the Uninsured: A Review of the Literature," Occasional Paper no. 8 (Washington: Urban Institute, July 1998).
7. K. Short, "Health Insurance Coverage: 1987-1990," Current Population Reports, Series P-70, no. 29 (Washington: U.S. Department of Commerce, Bureau of the Census, 1992); and K. Swartz, "Interpreting Estimates from Four National Surveys of the Number of People without Health Insurance," Journal of Economic and Social Measurement 14, no. 3 (1986): 233-242. For an ex-cellent discussion of the health insurance data issues in various data sets, see K. Lewis, M. Ellwood, and J.L Czajka, "Counting the Uninsured: A Review of the Literature," Occasional Paper no. 8 (Washington: Urban Institute, July 1998).
8. Age and family income are typically combined because of the rules governing Medicaid eligibility. Unfortunately, combining age and family income did not yield meaningful results because of small sample sizes. The results are not presented in this paper but are available from the author upon request: EBRI, Suite 600, 2121 K Street, NW, Washington, D.C. 20037-1896.
9. Contrary to popular belief, the distribution of workers has been shifting from small firms to large firms since as far back as 1988. For data between 1988 and 1993, see P. Fronstin and S.C. Snider, "An Examination of the Decline in Employment-Based Health Insurance between 1988 and 1993," Inquiry (Winter 1996/97): 317-325. For the 1994 and 1997 data, see Sources of Coverage and Characteristics of the Uninsured: Analysis of the March 1995 Current Population Survey, EBRI Issue Brief no. 170 (Washington: Employee Benefit Research Institute, February 1996); and P. Fronstin, Sources of Coverage and Characteristics of the Uninsured: Analysis of the March 1998 Current Population Suney, EBRI Issue Brief no. 204 (Washington: EBRI, December 1998).
10. Contrary to popular belief, the distribution of workers has been shifting from small firms to large firms since as far back as 1988. For data between 1988 and 1993, see P. Fronstin and S.C. Snider, "An Examination of the Decline in Employment-Based Health Insurance between 1988 and 1993," Inquiry (Winter 1996/97): 317-325. For the 1994 and 1997 data, see Sources of Coverage and Characteristics of the Uninsured: Analysis of the March 1995 Current Population Survey, EBRI Issue Brief no. 170 (Washington: Employee Benefit Research Institute, February 1996); and P. Fronstin, Sources of Coverage and Characteristics of the Uninsured: Analysis of the March 1998 Current Population Suney, EBRI Issue Brief no. 204 (Washington: EBRI, December 1998).
11. Contrary to popular belief, the distribution of workers has been shifting from small firms to large firms since as far back as 1988. For data between 1988 and 1993, see P. Fronstin and S.C. Snider, "An Examination of the Decline in Employment-Based Health Insurance between 1988 and 1993," Inquiry (Winter 1996/97): 317-325. For the 1994 and 1997 data, see Sources of Coverage and Characteristics of the Uninsured: Analysis of the March 1995 Current Population Survey, EBRI Issue Brief no. 170 (Washington: Employee Benefit Research Institute, February 1996); and P. Fronstin, Sources of Coverage and Characteristics of the Uninsured: Analysis of the March 1998 Current Population Suney, EBRI Issue Brief no. 204 (Washington: EBRI, December 1998).
12. These findings are available from the author upon request.
13. It was the labor shortages of World War II that led to the expansion of employment-based health insurance coverage as we know it today.