This paper examines why health insurance coverage fell despite the lengthy economic boom of the 1990s. I show that insurance coverage declined primarily because fewer workers took up coverage when offered it, not because fewer workers were offered insurance or were eligible for it. The reduction in take-up is associated with the increase in employee costs for health insurance. Estimates suggest that increased costs to employees can explain the entire decline in take-up rates in the 1990s.
*Published: This paper was subsequently published as Employee Costs and the Decline in Health Insurance Coverage, David M. Cutler, in NBER book Frontiers in Health Policy Research, Volume 6 (2003)
Cutler, David M. "Employee Costs And The Decline In Health Insurance Coverage," Forum for Health Economics and Policy, 2003, v6, Article 3.
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