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21.01.2017 | Short Paper | Ausgabe 2/2017

International Journal of Health Economics and Management 2/2017

The availability and marginal costs of dependent employer-sponsored health insurance

International Journal of Health Economics and Management > Ausgabe 2/2017
G. Edward Miller, Jessica Vistnes, Matthew Buettgens, Lisa Dubay
Wichtige Hinweise
Disclaimer: The research in this paper was conducted while Edward Miller and Jessica Vistnes were also Census Bureau research associates at the Center for Economic Studies. The views expressed in this paper are those of the authors, and no official endorsement by the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services is intended or should be inferred, nor do they necessarily indicate concurrence by the Census Bureau. The results in this paper have been screened to ensure that no confidential information has been revealed. Matthew Buettgens and Lisa Dubay received funding from the National Institute for Health Care Reform and the Urban Institute.


In this study, we examine differences by firm size in the availability of dependent coverage and the incremental cost of such coverage. We use data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to show that among employees eligible for single coverage, dependent coverage was almost always available for employees in large firms (100 or more employees) but not in smaller firms, particularly those with fewer than 10 employees. In addition, when dependent coverage was available, eligible employees in smaller firms were more likely than employees in large firms to face two situations that represented the extremes of the incremental cost distribution: (1) they paid nothing for single or family coverage or (2) they paid nothing for single coverage but faced a high contribution for family coverage. These results suggest that firm size may be an important factor in policy assessments, such as analyses of the financial implications for families excluded from subsidized Marketplace coverage due to affordable offers of single coverage or of potential rollbacks to public coverage for children.

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