http://faculty.smu.edu/millimet/classes/eco7321/papers/royalty%20abraham.pdf

Health insurance and labor market outcomes: Joint decision-making within households

The weak response by the uninsured to policy initiatives encouraging voluntary enrollment in health insurance has raised concerns regarding the extent to which the uninsured value health insurance. To address this issue, we use data from the 2001 Medical Expenditure Panel Survey to examine the association between health insurance preferences and coverage status. We also consider the role of such preferences in decisions to seek out and enroll in employment-based coverage. We find that adults with weak or uncertain preferences for health insurance are more likely than persons with strong preferences to be uninsured and less likely to acquire coverage. Our econometric work indicates that workers with weak or uncertain preferences are less likely to obtain job offers with insurance, reinforcing prior evidence that workers sort among jobs according to preferences for coverage. We also find that workers with weak or uncertain preferences are less likely to enroll in offered coverage and we estimate the subsidy necessary to compensate such workers for the utility loss were they to enroll. Our results suggest a dual approach to expanding coverage that includes both subsidies and educational efforts to inform targeted groups among the uninsured about the value of health insurance.

Health Insurance Enrollment Decisions: Preferences for Coverage, Worker Sorting, and Insurance Take Up

A common prescription for reducing the number of uninsured is to increase the tax subsidization of health insurance in the U.S. Yet, we already provide over $100 billion per year in tax subsidies to health insurance. This paper provides an assessment of the past and potential impacts of taxation on health insurance coverage and costs. I begin by reviewing the central facts on health insurance and taxation. I then provide a framework for assessing the impacts of tax policies on health insurance coverage and costs, and I review the existing empirical evidence on the key behavioral parameters required to model these impacts. I conclude with the policy implications of these findings for tax policies to expand insurance coverage.

/pdf/taxes-and-health-insurance-qvs41o9t48.pdf

Taxes and Health Insurance

The weak response by the uninsured to initiatives encouraging voluntary enrollment in health insurance has raised concerns regarding the extent to which the uninsured value insurance. This concern is also relevant for proposals to mandate health insurance coverage since workers will suffer welfare losses if compelled to purchase coverage they perceive to be of little value. To address this issue, we use the 2001 Medical Expenditure Panel Survey to examine decisions by single workers to seek out and enroll in employer-sponsored insurance. We find that single workers with weak or uncertain preferences for health insurance are less likely to have jobs that offer coverage or to enroll in coverage when offered. Our results suggest a dual approach to expanding coverage that includes both subsidies and educational efforts regarding the value of health insurance.

/pdf/health-insurance-enrollment-decisions-preferences-for-4t1djc8s7k.pdf

Health insurance enrollment decisions: preferences for coverage, worker sorting, and insurance take-up.

Understanding how households make health insurance choices is of critical importance in evaluating issues of equity and efficiency in health care markets. We consider a largely neglected aspect of such decision making: the decision of families with two working spouses to obtain double coverage. Using data from the 1987 National Medical Expenditure Survey, we find that household decisions to obtain double coverage are especially sensitive to the wife's out-of-pocket premium costs. Our analysis reveals that households with double coverage have more generous insurance, as reflected in their higher coverage rates for specific types of benefits. Moreover, our evidence suggests that the presence of duplicate health benefits in double-covered households may reflect a conscious attempt by working spouses to obtain more extensive coverage.

Health Insurance Choices in Two-Worker Households Determinants of Double Coverage

Understanding how households make health insurance choices is of critical importance in evaluating issues of equity and efficiency in health care markets. We consider a largely neglected aspect of such decision making: the decision of families with two working spouses to obtain double coverage. Using data from the 1987 National Medical Expenditure Survey, we find that household decisions to obtain double coverage are especially sensitive to a couple's out-of-pocket premium costs. Our analysis also reveals that households with double coverage have more generous insurance, as reflected in their higher coverage rates for specific types of benefits. We also demonstrate that the presence of duplicate health benefits in double-covered households is not random, possibly reflecting a systematic attempt by working spouses to obtain more extensive coverage.

Health insurance choices in two-worker households: determinants of double coverage.

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Health Insurance Choices in Two-Worker Households Determinants of Double Coverage

Health insurance choices in two-worker households: determinants of double coverage.