Skip to main content
Erschienen in: Journal of General Internal Medicine 7/2021

26.03.2021 | Original Research

Insurance Coverage for Non-standard Workers: Experiences of Temporary Workers, Freelancers, and Part-time Workers in the USA, 2010–2017

verfasst von: Terceira Ann Berdahl, PhD, Asako S. Moriya, PhD

Erschienen in: Journal of General Internal Medicine | Ausgabe 7/2021

Einloggen, um Zugang zu erhalten

Abstract

Objective

To estimate insurance disparities across non-standard employment categories and to determine how coverage disparities shifted following health reform in 2014.

Methods

We analyzed nationally representative data on working-age adults from the Medical Expenditure Panel Survey (MEPS) (2010–2012 and 2015–2017, N=79,182) to estimate insurance rates across three groups of non-standard workers (full-time temporary workers, freelancers, and part-time workers) compared to standard workers.

Results

Uninsurance decreased after health reform for all groups of non-standard workers, ranging from a 10.0- to 14.3-percentage point decline (p<0.001). Yet, uninsurance rates remained high for freelancers (30.8%), full-time temporary workers (25.1%), and part-time workers (17.9%) relative to standard workers (11.9%) in 2015–2017 (p<0.001). Residence in a Medicaid expansion state was associated with lower uninsurance rates for all categories of workers.

Conclusions

Workers in non-standard jobs continue to face challenges obtaining health insurance coverage. Our findings highlight the continued high risk of uninsurance for full-time temporary workers and freelancers.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Benach J, Benavides FG, Platt S, Diez-Roux A, Muntaner C. “The health-damaging potential of new types of flexible employment: a challenge for public health researchers.” American Journal of Public Health. 2000;90(8), 1316.CrossRef Benach J, Benavides FG, Platt S, Diez-Roux A, Muntaner C. “The health-damaging potential of new types of flexible employment: a challenge for public health researchers.” American Journal of Public Health. 2000;90(8), 1316.CrossRef
2.
Zurück zum Zitat U.S. Bureau of Labor Statistics. “Supplemental data measuring the effects of the coronavirus (COVID-19) pandemic on the labor market.” October 2, 2020. U.S. Bureau of Labor Statistics. “Supplemental data measuring the effects of the coronavirus (COVID-19) pandemic on the labor market.” October 2, 2020.
3.
Zurück zum Zitat Kalleberg AL, Reskin BF, Hudson K. “Bad jobs in America: Standard and nonstandard employment relations and job quality in the United States.” Am Sociol Rev. 2000;256-278. Kalleberg AL, Reskin BF, Hudson K. “Bad jobs in America: Standard and nonstandard employment relations and job quality in the United States.” Am Sociol Rev. 2000;256-278.
4.
Zurück zum Zitat Katz LF, Krueger AB. “The Rise and Nature of Alternative Work Arrangements in the United States, 1995–2015.” ILR Review. 2019;72(2) 382-416.CrossRef Katz LF, Krueger AB. “The Rise and Nature of Alternative Work Arrangements in the United States, 1995–2015.” ILR Review. 2019;72(2) 382-416.CrossRef
5.
Zurück zum Zitat Government Accountability Office (GAO) 2015. “Contingent Workforce: Size, Characteristics, Earnings, and Benefits” GAO-15-168R 2015. Government Accountability Office (GAO) 2015. “Contingent Workforce: Size, Characteristics, Earnings, and Benefits” GAO-15-168R 2015.
6.
Zurück zum Zitat Howard J. “Nonstandard work arrangements and worker health and safety.” American Journal of Industrial Medicine. 2017;60(1), 1-10.CrossRef Howard J. “Nonstandard work arrangements and worker health and safety.” American Journal of Industrial Medicine. 2017;60(1), 1-10.CrossRef
7.
Zurück zum Zitat Kalleberg AL. Good Jobs, Bad Jobs. New York, NY: Russell Sage Foundation; 2011. Kalleberg AL. Good Jobs, Bad Jobs. New York, NY: Russell Sage Foundation; 2011.
8.
Zurück zum Zitat Glauber RK. “Involuntary Part-Time Employment: A Slow and Uneven Economic Recovery.” The Carsey School of Public Policy at the Scholars' Repository. 2017;300. Glauber RK. “Involuntary Part-Time Employment: A Slow and Uneven Economic Recovery.” The Carsey School of Public Policy at the Scholars' Repository. 2017;300.
9.
Zurück zum Zitat Fronstin P. “Trends in Health Coverage for Part-Time Workers.” Employee Benefit Research Institute, May 34 No. 5; 2013. Fronstin P. “Trends in Health Coverage for Part-Time Workers.” Employee Benefit Research Institute, May 34 No. 5; 2013.
10.
Zurück zum Zitat Berdahl TA, Moriya AS. “Difference In Uninsurance Rates Between Full-And Part-Time Workers Declined In 2014.” Health Affairs. 2018;37(10): 1669-1672.CrossRef Berdahl TA, Moriya AS. “Difference In Uninsurance Rates Between Full-And Part-Time Workers Declined In 2014.” Health Affairs. 2018;37(10): 1669-1672.CrossRef
11.
Zurück zum Zitat Shafer HL. “Part-time workers: some key differences between primary and secondary earners.” Monthly Labor Review. 2009;1:3-15. Shafer HL. “Part-time workers: some key differences between primary and secondary earners.” Monthly Labor Review. 2009;1:3-15.
13.
Zurück zum Zitat Simon K, Soni A, Cawley J. The impact of health insurance on preventive care and health behaviors: evidence from the first two years of the ACA Medicaid expansions. Journal of Policy Analysis and Management. 2017;36(2), 390-417.CrossRef Simon K, Soni A, Cawley J. The impact of health insurance on preventive care and health behaviors: evidence from the first two years of the ACA Medicaid expansions. Journal of Policy Analysis and Management. 2017;36(2), 390-417.CrossRef
14.
Zurück zum Zitat Zhao G, Okoro CA, Li J, Town M. “Health insurance status and clinical cancer screenings among US adults.” American journal of preventive medicine. 2018;54(1), e11-e19.CrossRef Zhao G, Okoro CA, Li J, Town M. “Health insurance status and clinical cancer screenings among US adults.” American journal of preventive medicine. 2018;54(1), e11-e19.CrossRef
15.
Zurück zum Zitat Gottlieb L, et al. "Integrating social and medical data to improve population health: opportunities and barriers." Health Affairs. 2016;35.11: 2116-2123.CrossRef Gottlieb L, et al. "Integrating social and medical data to improve population health: opportunities and barriers." Health Affairs. 2016;35.11: 2116-2123.CrossRef
16.
Zurück zum Zitat Su CP, Asfaw A, Tamers SL, Luckhaupt SE. Health Insurance Coverage Among US Workers: Differences by Work Arrangements in 2010 and 2015. American journal of preventive medicine. 2019;56(5), 673-679.CrossRef Su CP, Asfaw A, Tamers SL, Luckhaupt SE. Health Insurance Coverage Among US Workers: Differences by Work Arrangements in 2010 and 2015. American journal of preventive medicine. 2019;56(5), 673-679.CrossRef
17.
Zurück zum Zitat Frean M, Gruber J, Sommers BD. Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act. J Health Econ. 2017;53:72-86.CrossRef Frean M, Gruber J, Sommers BD. Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act. J Health Econ. 2017;53:72-86.CrossRef
18.
Zurück zum Zitat Kaye, H. S. 2019. “Disability-related disparities in access to health care before (2008–2010) and after (2015–2017) the Affordable Care Act.” American Journal of Public Health, 109(7): 1015-1021.CrossRef Kaye, H. S. 2019. “Disability-related disparities in access to health care before (2008–2010) and after (2015–2017) the Affordable Care Act.” American Journal of Public Health, 109(7): 1015-1021.CrossRef
20.
Zurück zum Zitat Antonisse L, Garfield R, R Rudowitz, Artiga S. “The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review.” Kaiser Family Foundation, March Issue Brief, Washington, DC; 2018. Antonisse L, Garfield R, R Rudowitz, Artiga S. “The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review.” Kaiser Family Foundation, March Issue Brief, Washington, DC; 2018.
21.
Zurück zum Zitat Katz LF, KruegerAB. “The role of unemployment in the rise in alternative work arrangements.” American Economic Review.2017;107 (5): 388-92.CrossRef Katz LF, KruegerAB. “The role of unemployment in the rise in alternative work arrangements.” American Economic Review.2017;107 (5): 388-92.CrossRef
22.
Zurück zum Zitat McGrath DM, Keister LA. The effect of temporary employment on asset accumulation processes. Work and Occupations. 2008;35(2):196-222.CrossRef McGrath DM, Keister LA. The effect of temporary employment on asset accumulation processes. Work and Occupations. 2008;35(2):196-222.CrossRef
23.
Zurück zum Zitat Jackson E, Looney A, Ramnath S. 2017. The rise of alternative work arrangements: evidence and implications for tax filing and benefit coverage. Office of Tax Analysis Working Paper. 114. Jackson E, Looney A, Ramnath S. 2017. The rise of alternative work arrangements: evidence and implications for tax filing and benefit coverage. Office of Tax Analysis Working Paper. 114.
24.
Zurück zum Zitat Kalleberg AL, Vallas SP. “Probing precarious work: theory, research, and politics.” Research in the Sociology of Work, 2018; 31: 1–30. Kalleberg AL, Vallas SP. “Probing precarious work: theory, research, and politics.” Research in the Sociology of Work, 2018; 31: 1–30.
25.
Zurück zum Zitat Agarwal SD, Sommers BD. Insurance Coverage after Job Loss—The Importance of the ACA during the Covid-Associated Recession. New England Journal of Medicine. 2020. Agarwal SD, Sommers BD. Insurance Coverage after Job Loss—The Importance of the ACA during the Covid-Associated Recession. New England Journal of Medicine. 2020.
Metadaten
Titel
Insurance Coverage for Non-standard Workers: Experiences of Temporary Workers, Freelancers, and Part-time Workers in the USA, 2010–2017
verfasst von
Terceira Ann Berdahl, PhD
Asako S. Moriya, PhD
Publikationsdatum
26.03.2021
Verlag
Springer International Publishing
Erschienen in
Journal of General Internal Medicine / Ausgabe 7/2021
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-021-06700-0

Weitere Artikel der Ausgabe 7/2021

Journal of General Internal Medicine 7/2021 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Strenge Blutdruckeinstellung lohnt auch im Alter noch

30.04.2024 Arterielle Hypertonie Nachrichten

Ältere Frauen, die von chronischen Erkrankungen weitgehend verschont sind, haben offenbar die besten Chancen, ihren 90. Geburtstag zu erleben, wenn ihr systolischer Blutdruck < 130 mmHg liegt. Das scheint selbst für 80-Jährige noch zu gelten.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.