Older Adults and Their Health Insurance (original) (raw)
Related papers
2005
work was made possible by the financial support of the Economic Research Initiative on the Uninsured at the University of Michigan. The authors also gratefully acknowledge additional financial support from the National Institute on Aging under grant 1 P01 AG022481-01A1. Ben´ıtez-Silva is grateful for the hospitality of the Departments of Economics of the University of Maryland and Universitat Pompeu Fabra during the completion of this paper, and to the Fundaci´on BBVA for financial support. We thank the staff of the University of Michigan Survey Research Center and the Health and Retirement Study for answering numerous questions. The opinions expressed in this paper are ours alone and do not represent the opinions of ERIU, or the Board of Governors of the Federal Reserve System or its staff. This paper analyzes the dynamics of health insurance coverage, health expenditures, and health status in the decade expanding from 1992 to 2002, for a cohort of older Americans. We follow 13,594...
Health Status, Insurance, and Expenditures in the Transition from Work to Retirement
2005
This paper analyzes the dynamics of health insurance coverage, health expenditures, and health status in the decade expanding from 1992 to 2002, for a cohort of older Americans. We follow 13,594 individuals interviewed in Waves 1 to 6 of the Health and Retirement Study, most of whom were born between 1930 and 1940, as they transition from work into retirement. Although this i?½depression cohorti?½ is by and large fairly well prepared for retirement in terms of pension coverage and savings, we identify significant gaps in their health insurance coverage, especially among the most disadvantaged members of this cohort. We find that government health insurance programsi?½particularly Medicare and Medicaidi?½significantly reduce the number of individuals who are uninsured and the risks of large out of pocket health care costs. However, prior to retirement large numbers of these respondents were uninsured, nearly 18% at the first survey in 1992. Moreover, a much larger share, about 55% of...
2005
This paper analyzes the dynamics of health insurance coverage, health expenditures, and health status in the decade expanding from 1992 to 2002, for a cohort of older Americans. We follow 13,594 individuals interviewed in Waves 1 to 6 of the Health and Retirement Study, most of whom were born between 1930 and 1940, as they transition from work into retirement. Although this “depression cohort” is by and large fairly well prepared for retirement in terms of pension coverage and savings, we identify significant gaps in their health insurance coverage, especially among the most disadvantaged members of this cohort. We find that government health insurance programs— particularly Medicare and Medicaid—significantly reduce the number of individuals who are uninsured and the risks of large out of pocket health care costs. However, prior to retirement large numbers of these respondents were uninsured, nearly 18% at the first survey in 1992. Moreover, a much larger share, about 55% of this c...
Health Services Research, 2006
Objective. Primarily, to determine if the presence of private insurance leads to improved health status, as measured by a survey-based health score. Secondarily, to explore sensitivity of estimates to adjustments for endogeneity. The study focuses on adults in late middle age who are nearing entry into Medicare. Data Sources. The analysis file is drawn from the Health and Retirement Study, a national survey of relatively older adults in the labor force. The dependent variable, an index of 5 health outcome items, was obtained from the 1996 survey. Independent variables were obtained from the 1992 survey. State-level instrumental variables were obtained from the Area Resources File and the TAXSIM file. The final sample consists of 9,034 individuals of which 1,540 were uninsured. Study Design. Estimation addresses endogeneity of the insurance participation decision in health score regressions. In addition to ordinary least squares (OLS), two models are tested: an instrumental variables (IV) model, and a model with endogenous treatment effects due to Heckman (1978). Insurance participation and health behaviors enter with a lag to allow their effects to dissipate over time. Separate regressions were run for groupings of chronic conditions. Principal Findings. The OLS model results in statistically significant albeit small effects of insurance on the computed health score, but the results may be downward biased. Adjusting for endogeneity using state-level instrumental variables yields up to a six-fold increase in the insurance effect. Results are consistent across IV and treatment effects models, and for major groupings of medical conditions. The insurance effect appears to be in the range of about 2-11 percent. There appear to be no significant differences in the insurance effect for subgroups with and without major chronic conditions. Conclusions. Extending insurance coverage to working age adults may result in improved health. By conjecture, policies aimed at expanding coverage to this population may lead to improved health at retirement and entry to Medicare, potentially leading to savings. However, further research is needed to determine whether similar results are found when alternative measures of overall health or health scores are used. Future
Older Workers’ Access to Employer-Sponsored Retiree Health Insurance, 2000–2006
Journal of Labor Research, 2009
Using a multivariate framework, we analyze recent trends in employer provision of retiree health insurance (RHI), eligibility for new retirees, and retiree contribution requirements. We also explore whether local labor market characteristics such as the unemployment rate influence RHI provision. Finally, we examine whether the Medicare Modernization Act (MMA) was associated with diverging trends in RHI access for Medicare-eligible and early retirees. Data come for the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC). We find that, while RHI provision to existing retirees remained stable, eligibility for new retirees declined, and contribution requirements increased between 2000 and 2004. The local labor market had no effect on RHI provision. While early retiree coverage was more common than coverage for Medicare-eligible retirees, we did not find a divergence subsequent to MMA. These results suggest growing financial instability for retirees, both because RHI contribution requirements increased, and because businesses dropped coverage for new retirees.
Health insurance coverage among the elderly
1994
The research reported in this paper examines the decision to have private health insurance by elderly Medicare enrollees. Models allowing both stimultaneity and a joint error structure between health insurance and use of medical care are considered. We find that common unobserved variables underlying the joint errors are important determinants in the decision to purchase private health insurance. Simultaneity is present only between the decision to have private health insurance and the probability of visiting a doctor. Health status and functional limitations are important determinants of the decision to have private health insurance in addition to Medicare coverage. Other personal characteristics (age, sex, race and education), as well as household income, Medicaid enrollment, and the employment of a family member are also found to be related to the decision to have private health insurance.
The Effect of Health Insurance on Retirement
Brookings Papers on Economic Activity, 1994
FOR DECADES health insurance in the United States has been provided to most nonelderly Americans through their own or a family member's employment. This system of employment-based health insurance has evolved largely because of the substantial cost advantages that employers enjoy in supplying health insurance. By pooling large numbers of individuals, employers face significantly lower administrative expenses than do individuals. In addition, employer expenditures on health insurance are tax deductible, but individual expenditures are generally not. I Despite these cost advantages, there is widespread dissatisfaction with this system of employment-based health insurance. Many people are excluded because not all employers provide health insurance and not all individuals live in households in which someone is employed. An estimated 36 million Americans were uninsured in 1990.2 Even among those fortunate enough to have employer-provided health insurance, there is mounting concern that it discourages individuals with preexisting conditions from changing jobs and, for those who do change jobs, it often means finding a new doctor because insurance plans vary from firm to firm.