Health benefits in 2004: Four years of double-digit premium increases take their toll on coverage

Health Affairs

Volumn 23, Issue 5, 2004, Pages 200-209

  Gabel, Jon ^a   Claxton, Gary ^b   Gil, Isadora ^b   Pickreign, Jeremy ^a   Whitmore, Heidi ^a   Holve, Erin ^b   Finder, Benjamin ^c   Hawkins, Samantha ^a   Rowland, Diane ^c  

^a Health Research and Educational Trust   (United States)

^b HENRY J KAISER FAMILY FOUNDATION   (United States)

^c Kaiser Family Foundation ^*

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; ECONOMIC ASPECT; EMPLOYEE; EMPLOYER; FAMILY; HEALTH CARE ACCESS; HEALTH CARE DISTRIBUTION; HEALTH CARE PLANNING; HEALTH INSURANCE; HUMAN;

HEALTH BENEFIT PLANS, EMPLOYEE; INSURANCE COVERAGE; INSURANCE, HEALTH, REIMBURSEMENT; MANAGED CARE PROGRAMS; UNITED STATES;

EID: 4644251815     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.23.5.200     Document Type: Article

References (14)

1. P. Fronstin, "Sources of Health Insurance and Characteristics of the Uninsured: Analysis of the March 2003 Current Population Survey," Issue Brief no. 264 (Washington: Employee Benefit Research Institute, December 2003).
2. J. Gabel et al., "Health Benefits in 2003: Premiums Reach Thirteen-Year High as Employers Adopt New Forms of Cost Sharing," Health Affairs 22, no. 5 (2003): 117-125.
3. Premium-increase figures are based on respondents' answers to two questions: "How do the total costs for family coverage compare with what they were one year ago?" and "What percentage did costs for family coverage increase (decrease) since last year?" There are no adjustments in the premium-increase figures for benefit adjustments.
4. The Consumer Price Index (CPI) rose 2.3 percent, and workers' hourly wages increased 2.2 percent for this same period of time, according to the U.S. Bureau of Labor Statistics.
5. B. Strunk and P. Ginsburg, "Tracking Health Care Costs: Trends Turn Downward in 2003," Health Affairs, 9 June 2004, content.healthaffairs.org/ cgi/content/abstract/hlthaff.w4.354 (1 July 2004).
6. J.M. Grossman and P.B. Ginsburg, "As the Health Insurance Underwriting Cycle Turns: What Next?" Health Affairs (forthcoming).
7. Surveys from the 1990s did not ask about the presence of such cost-sharing arrangements because these arrangements were so uncommon.
8. The Henry J. Kaiser Foundation and the Health Research and Educational Trust annual survey rotates the questions on covered benefits each year. Consequently, it is not possible to compare 2004 figures with a standard base year.
9. In fairness, consolidation and exit of many insurers and managed care organizations may be a factor in determining this 13 percent figure.
10. The change in offer rate by all small firms is not statistically significantly different between 2003 and 2004, but it is significantly different from 2000 to 2004 and from 2001 to 2004 (p < .10).
11. We calculated this loss-of-jobs figure as the difference in the number of workers multiplied by the coverage rate for 2001 and 2004. The coverage rate includes employees in firms that do and do not offer coverage. Our estimate does not account for the decline in employment between 2001 and 2004, although data from the Bureau of Labor Statistics show that employment declined from 132.2 million in April 2001 to 131.0 million in April 2004. The manufacturing sector, a sector with a high rate of coverage, lost 2.9 million jobs during this period. Accounting for declines in employment would raise our estimate of the number of jobs with health insurance lost. Our estimate also assumes that the mix of employment in industries did not change (no firm-size/industry-mix data are available for 2004). People in firms with fewer than three employees and the self-employed are also excluded from the estimate.
12. Estimates of dual coverage are from the Medical Expenditure Panel Survey (MEPS) and were provided by Joel Cohen of the Agency for Healthcare Research and Quality (AHRQ).
13. The change is significant only at the .10 level.
14. Strunk and Ginsburg, "Tracking Health Care Costs: Trends Turn Downward in 2003."