Union Effects on Health Insurance Provision and Coverage in the United States

Thomas C. Buchmueller, John DiNardo

NBER Working Paper No. 8238
Issued in April 2001
NBER Program(s):Health Economics, Labor Studies

During the past two decades, union density has declined in the United States and employer provision of health benefits has undergone substantial changes in extent and form. Using individual data spanning the years 1983-1997, combined with establishment data for 1993, we update and extend previous analyses of private-sector union effects on employer-provided health benefits. We find that the union effect on health insurance coverage rates has fallen somewhat but remains large, due to an increase over time in the union effect on employee 'take-up' of offered insurance, and that declining unionization explains 20-35 percent of the decline in employee health coverage. The increasing union take-up effect is linked to union effects on employees' direct costs for health insurance and the availability of retiree coverage.

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Document Object Identifier (DOI): 10.3386/w8238

Published: Thomas C. Buchmueller & John DiNardo & Robert G. Valletta, 2002. "Union effects on health insurance provision and coverage in the United States," Industrial and Labor Relations Review, ILR Review, ILR School, Cornell University, vol. 55(4), pages 610-627, July. citation courtesy of

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