Abstract:
OBJECTIVE:We investigate the factors driving the downward trend in employer sponsored health insurance (ESI) coverage between 1999 and 2002 for low- and middle-income workers, and assess their insurance options in the absence of ESI coverage. DATA:We use the 1999 and 2002 rounds of the National Survey of America's Families (NSAF), supplemented with ESI premiums from the Medical Expenditure Panel Survey, as well as other state- and county-level data from a variety of sources. The sample includes workers between the ages of 19 and 64. STUDY DESIGN:We first estimate linear probability models of the probability of having an ESI offer and, for those with an offer, the probability of taking up ESI coverage, using two-stage least square regression on the 2002 worker sample. We then use Oaxaca-Blinder regression-based decomposition methods to identify the factors that explain the changes in ESI offer and take-up between 1999 and 2002. PRINCIPAL FINDINGS:We find that while low-income workers are more likely to be uninsured and are most vulnerable to the loss of ESI coverage, many middle-income workers are also in a precarious position when faced with the loss of ESI coverage. Many low- and middle-income workers have few coverage options in the absence of ESI. This is particularly problematic for low-income workers: only 13 percent have a spouse with an ESI offer and the nongroup premium they face increased at a much higher rate than for middle-income workers. Finally, we find that the drop in ESI offers between 1999 and 2002 was driven largely by changes in nature of the workers' jobs, while the drop in ESI take-up was driven largely by rising ESI premiums. CONCLUSIONS:Policies that shore up the ESI system are important for both low- and middle-income workers, as both are vulnerable to a loss of insurance coverage in the absence of ESI. Over time, the potential coverage options available to low- and middle-income workers in the absence of ESI have narrowed as nongroup premiums have increased. While public coverage has provided some protection from that increase for low-income workers, middle-income workers are much less likely to have access to public protection.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Shen YC,Long SKdoi
10.1111/j.1475-6773.2006.00590.xsubject
Has Abstractpub_date
2006-12-01 00:00:00pages
2074-96issue
6eissn
0017-9124issn
1475-6773pii
HESR590journal_volume
41pub_type
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journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13570
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study is to determine whether women who have been diagnosed with HIV utilize the same volume of medical care services as men who have been diagnosed with HIV. DATA SOURCES:This study uses data from the first wave of interviews of the AIDS Cost and Service Utilization Survey (ACSUS) conduc...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract:OBJECTIVE:To explore and understand approaches to user engagement through investigating the range of ways in which health care workers and organizations accommodated the introduction of computerized physician order entry (CPOE) and computerized decision support (CDS) for hospital prescribing. STUDY SETTING:Six hospita...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12581
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:To test whether concordance or discordance of patient participation between patients and physicians is associated with higher satisfaction, and to examine the effects of patients' and physicians' participatory styles on patients' satisfaction with their physicians. DATA:Data collected in the Texas Tech 5000...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00233.x
更新日期:2004-04-01 00:00:00
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journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13621
更新日期:2021-01-11 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00423.x
更新日期:2005-10-01 00:00:00
abstract::In this paper I propose a methodology for paying short-term general hospitals on the basis of prospective cost-based case-mix revenue budgets. A hospital's budget is divided into patient care--related components and other components. The patient care--related budget is based on the case mix of patients treated by the ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1980-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00688.x
更新日期:2007-08-01 00:00:00
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journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2008.00835.x
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:To assess optimal activity size/mix of Connecticut local public health jurisdictions, through estimating economies of scale/scope/specialization for environmental inspections/services. DATA SOURCES/STUDY SETTING:Connecticut's 74 local health jurisdictions (LHJs) must provide environmental health services, bu...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12740
更新日期:2017-12-01 00:00:00
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journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00142
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:To examine the effect of the Medicare prospective payment system (PPS) for skilled nursing facilities (SNF) on the delivery of rehabilitation therapy to residents. DATA SOURCES:Resident-level data are based on the Resident Assessment Instrument Minimum Data Set for nursing facilities. All elderly residents a...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00291.x
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:Evaluate the association between opioid therapy and health-related quality of life (HRQoL) in participants with chronic, noncancer pain (CNCP). DATA SOURCES:Medical Expenditure Panel Survey Longitudinal, Medical Conditions, and Prescription Files. STUDY DESIGN:Using a retrospective cohort study design, the ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12836
更新日期:2018-10-01 00:00:00
abstract::All admissions to a 1,100-bed Department of Veterans Affairs (VA) hospital were screened to identify 171 terminally ill patients with informal caregivers who were then randomly assigned to VA hospital-based team home care (HBHC, N = 85) or customary care (N = 86). Patient functioning, and patient and caregiver morale ...
journal_title:Health services research
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1992-02-01 00:00:00
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journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1475-6773.2010.01210.x
更新日期:2011-04-01 00:00:00
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journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2009.00967.x
更新日期:2009-08-01 00:00:00
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journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1975-10-01 00:00:00
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journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
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journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1976-10-01 00:00:00
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更新日期:2000-06-01 00:00:00
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doi:
更新日期:2000-10-01 00:00:00
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journal_title:Health services research
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doi:10.1111/j.1475-6773.2006.00606.x
更新日期:2007-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/1475-6773.12444
更新日期:2016-08-01 00:00:00
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journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
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journal_title:Health services research
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更新日期:2015-06-01 00:00:00
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更新日期:2020-08-13 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00820.x
更新日期:2008-06-01 00:00:00