Coverage For Self-Employed And Others Without Employer Offers Increased After 2014

Decker, Sandra L.; Moriya, Asako S.; Soni, Aparna

doi:10.1377/hlthaff.2017.1663

Cited by 7 publications

(9 citation statements)

References 7 publications

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“…The Guide to Community Preventive Services recommends reducing out-of-pocket costs for evidence-based cessation treatments to reduce tobacco use (5). Employers can offer treatment benefits via employersponsored health insurance to help reduce treatment costs or copayments (5,22). Since the Affordable Care Act mandated the provision of preventive services, offering these benefits is now a requirement for employers with 50 or more full-time employees.…”

Section: Discussionmentioning

confidence: 99%

Use of Cigarettes and E-Cigarettes and Dual Use Among Adult Employees in the US Workplace

2020

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What is already known on this topic? US smoking rates have steadily declined over time, but e-cigarette use and dual use are becoming increasingly popular. Increased worksite evidencebased interventions are still needed for tobacco control. What is added by this report? Employment type, age, sex, race/ethnicity, education, and health care coverage were associated with e-cigarette use and dual cigarette and ecigarette use. Recent quit attempts were higher among dual users. Tobacco-product use varied by state. What are the implications for public health practice? These findings suggest the importance of targeting efforts when designing and implementing worksite interventions for tobacco control and cessation in the workplace.

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Section: Discussionmentioning

confidence: 99%

Use of Cigarettes and E-Cigarettes and Dual Use Among Adult Employees in the US Workplace

2020

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“…Prior studies found that concerns about losing health insurance coverage can contribute to “job lock” and that increasing access to nonemployer‐sponsored health insurance may promote entrepreneurialism 10‐14 . Further, a prior study found that the ACA did help improve insurance coverage among those who are self‐employed 28 . The current study suggests a potential mechanism for these findings (exchange‐based coverage), and adds evidence that despite ACA improvements, a substantial portion of self‐employed individuals remain uninsured.…”

Section: Discussionmentioning

confidence: 99%

Health insurance coverage and self‐employment

Berkowitz

Gold

Domino

et al. 2020

Health Services Research

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Background Self‐employed workers are 10% of the US labor force, with growth projected over the next decade. Whether existing policy mechanisms are sufficient to ensure health insurance coverage for self‐employed workers, who do not have access to employer‐sponsored coverage, is unclear. Objective To determine whether self‐employment is associated with lack of health insurance coverage. Data Sources Secondary analysis of Medical Expenditure Panel Survey (MEPS) data collected 2014‐2017. Study Design Participants were working age (18‐64 years), employed, civilian noninstitutionalized US adults with two years of Medical Expenditure Panel Survey (MEPS) participation in 2014‐2017. We compared those who were employees vs those who were self‐employed. Key outcomes were self‐report of health insurance coverage, and of delaying needed medical care. Data Extraction Methods Longitudinal design among individuals who were employees during study year 1, comparing health insurance coverage among those who did vs did not transition to self‐employment in year 2. Principal Findings 16 335 individuals, representing 121 473 345 working‐age adults, met inclusion criteria; of these, 147, representing 1 097 582 individuals, transitioned to self‐employment. In unadjusted analyses, 25.7% of those who became self‐employed were uninsured in year 2, vs 8.1% of those who remained employees (P < .0001). In adjusted models, self‐employment was associated with greater risk of being uninsured (26.1% vs 8.0%, risk difference 18.0%, 95% confidence interval [CI] 9.2% to 26.9%, P = .0001). A time‐by‐employment type product term suggests that 10.0 percentage points (95%CI 0.3 to 19.7 percentage points, P = .04) of the risk difference may be attributable to the change to self‐employment. Self‐employment was also associated with delaying needed medical care (12.0% vs 3.1%, risk difference: 8.9%, 95% CI 3.1% to 14.6%, P = .003). Conclusions One in four self‐employed workers lack health insurance coverage. Given the rise in self‐employment, it is imperative to identify ways to improve health care insurance access for self‐employed working‐age US adults.

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“…Our paper relates to an important and growing literature on the impacts of the Affordable Care Act. Overall, the literature has found that the ACA and SME in particular have increased health insurance coverage rates among both workers and non-workers (Courtemanche et al 2017;Frean et al 2017;Kaestner et al 2017;Decker et al 2018;Hu et al 2018;Antonisse et al 2019;Courtemanche et al 2019a,b;Gallagher et al 2019;Gruber and Sommers 2019). 4 However, Decker et al (2018) is the only previous study to specifically examine ACA effects on health insurance coverage of the self-employed.…”

Section: Introductionmentioning

confidence: 99%

“…Overall, the literature has found that the ACA and SME in particular have increased health insurance coverage rates among both workers and non-workers (Courtemanche et al 2017;Frean et al 2017;Kaestner et al 2017;Decker et al 2018;Hu et al 2018;Antonisse et al 2019;Courtemanche et al 2019a,b;Gallagher et al 2019;Gruber and Sommers 2019). 4 However, Decker et al (2018) is the only previous study to specifically examine ACA effects on health insurance coverage of the self-employed. Decker et al (2018) examine the National Health Interview Survey (NHIS) to document national-level increases in health insurance coverage for the self-employed and others without employer-offered health insurance.…”

Section: Introductionmentioning

confidence: 99%

“…4 However, Decker et al (2018) is the only previous study to specifically examine ACA effects on health insurance coverage of the self-employed. Decker et al (2018) examine the National Health Interview Survey (NHIS) to document national-level increases in health insurance coverage for the self-employed and others without employer-offered health insurance. However, the publicly available NHIS microdata do not include state-level identifiers, so Decker et al (2018) do not examine treatment effects from state Medicaid expansions.…”

Section: Introductionmentioning

confidence: 99%

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State Medicaid Expansion and the Self-Employed

Lee

Winters

2021

Small Bus Econ

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Any opinions expressed in this paper are those of the author(s) and not those of IZA. Research published in this series may include views on policy, but IZA takes no institutional policy positions. The IZA research network is committed to the IZA Guiding Principles of Research Integrity. The IZA Institute of Labor Economics is an independent economic research institute that conducts research in labor economics and offers evidence-based policy advice on labor market issues. Supported by the Deutsche Post Foundation, IZA runs the world's largest network of economists, whose research aims to provide answers to the global labor market challenges of our time. Our key objective is to build bridges between academic research, policymakers and society. IZA Discussion Papers often represent preliminary work and are circulated to encourage discussion. Citation of such a paper should account for its provisional character. A revised version may be available directly from the author.

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Coverage For Self-Employed And Others Without Employer Offers Increased After 2014

Cited by 7 publications

References 7 publications

Use of Cigarettes and E-Cigarettes and Dual Use Among Adult Employees in the US Workplace

Use of Cigarettes and E-Cigarettes and Dual Use Among Adult Employees in the US Workplace

Health insurance coverage and self‐employment

State Medicaid Expansion and the Self-Employed

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