The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #55820

Ning Lu, PhD, MPH, Tracey Young, EdD, MS, and Wayne Higgins, PhD. Department of Public Health, Western Kentucky University, 1 Big Red Way, Bowling Green, KY 42101-3576, 270-745-5260, ning.lu@wku.edu

Given the importance of current employer-based health insurance coverage system, this paper examines the trend in job-based health insurance coverage, by addressing following questions: 1) was there any change in health insurance coverage for employed workers between 1995 and 2001; 2) did the change vary by age, sex, race, education and income? We used data from Kentucky Behavioral Risk Factor Surveillance System (BRFSS), which collected health insurance, demographic and socioeconomic information from a representative sample of Kentucky's adult population. The main variable of interest for this study is whether a worker has any type of health insurance, with analyses focused only on those employed for wages, ages eighteen to sixty-four. For all analyses standard errors were adjusted for the complex survey design. Our data revealed that, between 1995 to 2001, health insurance coverage declined for workers of all ages with the deepest decline among the oldest age group (³55 years), for both men and women. The decline in coverage for Black males (6.5%) exceeded that for white males (2.7%). We also found that the uninsurance rate increased 10.3 percentage points for lowest-income workers from 38% in 1995 to 48.3% in 2001. No significant changes in insurance status were found for highest-income group. Some of the observed declines could be related to health insurance reforms enacted in Kentucky in 1994. While employment-based health insurance coverage is a fundamental component of our health insurance system, the study found that the job-based health insurance coverage is eroding especially among minorities and low-income workers.

Learning Objectives:

At the conclusion of the session, the participants in this session will be able to:
• Realize that with medical cost soaring, health insurance premiums on the rise, and the number of uninsured and underinsured increasing, our current employer-based health insurance coverage system is most likely to be an issue in any health care reform debate.
• Recognize that while our current employment-based health insurance coverage is a fundamental mechanism to enhance our health insurance system, the job-based health insurance coverage is eroding, especially among minorities and low-income workers.
• Realize that identifying likely successful mechanisms in addition to employer-based system to provide workers health insurance is needed.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.