labor market effects of the pre-paid health care act of 1974: estimates from the cps 1988-2003

This research is funded in part through a U.S. Health Resources and Services Administration, State Planning Grant to the Hawaii State Department of Health, Prime Contract No. 1 P09 OA 00046-01. Sub-Contract Research Corporation of the University of Hawaii, Project No.

659075. Research conducted by the University of Hawaii, Social Science Research Institute in collaboration with the Hawaii State Department of Health, Hawaii Institute for Public Affairs/Hawaii Uninsured Project and the Hawaii Health Information Corporation.

Labor Market Effects of the Pre-Paid Health Care Act of

1974: Estimates from the CPS 1988-2003

Sang-Hyop LeeGerard Russo Lawrence NitzAbdul Jabbar

University of Hawai`i at Mānoa

Hawai`i Coverage for All Project

29 March 2004

Preliminary results. Please do not quote without permission.

Research Questions

What is the impact of PHCA on hours worked?

What is the impact of PHCA on insurance coverage?


Data and Method

Current Population Survey (CPS) March Demographic Supplement 1988-2003

Two separate analyses: 1988-1993 and 1994-2003 Analyze the performance of Hawaiian system after

implementation of the PHCA relative to the other states and US

US, Hawaii, Nevada, Michigan, California, and Florida

Counter-factual analysis.


Percent Insured by Type of Insurance, CPS 1994-2003

(%)

Insured

Uninsured Total

Public Private

Medicare MedicaidSubTotal Emp.

SubTotal Insured

Hawaii 13.1 11.0 32.1 65.8 73.6 90.5 9.5 100.0

US 13.2 11.3 25.4 61.6 70.6 84.8 15.2 100.0

Nevada 12.4 16.8 20.9 64.4 71.6 82.3 17.7 100.0

Michigan 13.2 11.8 24.5 69.9 77.9 89.2 10.8 100.0

California 10.9 14.4 25.6 54.7 62.8 80.0 20.0 100.0

Florida 18.1 10.6 29.8 53.8 65.2 81.9 18.1 100.0


Percent Insured by Type of Insurance, CPS 1988-1993

(%)

Insured

Uninsured Total

Public Private

Medicare MedicaidSubTotal Emp.

SubTotal Insured

Hawaii 11.4 7.1 30.1 63.8 77.5 92.5 7.5 100.0

US 12.9 9.6 24.3 60.6 73.5 86.2 13.8 100.0

Nevada 10.7 4.9 19.7 61.5 72.5 81.5 18.5 100.0

Michigan 12.5 12.3 25.2 68.0 78.9 91.3 8.7 100.0

California 10.9 12.3 25.2 54.6 66.3 81.5 18.5 100.0

Florida 17.6 8.4 29.6 51.9 68.0 81.9 18.1 100.0


Percent Distribution of Employees by Hours Worked: CPS 1994-2003

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

1-5 6 - 10 11-15 16-19 20 21-25 26-30 31-35 35-39

Hours worked

Pe

rce

nt

dis

trib

uti

on

HI

US

NV

MI

CA

FL


Percent Distribution of Employees by Hours Worked: CPS 1988-1993

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

1-5 6 - 10 11-15 16-19 20 21-25 26-30 31-35 35-39

Hours worked

Pe

rce

nt

dis

trib

uti

on

HI

US

NV

MI

CA

FL


Estimating the effect of PHCA

Methodology: multinomial logit model Three categories: uninsured, employment

based insurance, or other insurance Predictor variables: age, sex, income,

working hours, ethnicity, industry of employment, and collective bargaining.

Predict the effect of hours worked on probability in coverage: impact working hours holding other characteristics constant.


The effect of PHCA on the percent uninsured: CPS 1994-2003

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

1-5 6-10 11-15 16-19 20 21-25 26-30 31-35 36-39 40 &more

Hours worked

Pe

rce

nt

un

ins

ure

d

HI

US

NV

MI

CA

FL


The effect of PHCA on the percent covered by employment-based insurance: CPS 1994-2003

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

1-5 6-10 11-15 16-19 20 21-25 26-30 31-35 36-39 40 &more

Hours worked

Pe

rce

nt

ins

ure

d

HI

US

NV

MI

CA

FL


The effect of PHCA on the percent covered by non-employment based insurance: CPS 1994-2003

0.0%

10.0%

20.0%

30.0%

40.0%

1-5 6-10 11-15 16-19 20 21-25 26-30 31-35 36-39 40 &more

Hours worked

Pe

rce

nt

ins

ure

d HI

US

NV

MI

CA

FL


The effect of PHCA on the percent uninsured: CPS 1988-1993

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

1-5 6-10 11-15 16-19 20 21-25 26-30 31-35 36-39 40 &more

Hours worked

Pe

rce

nt

un

ins

ure

d

HI

US

NV

MI

CA

FL


The effect of PHCA on the percent covered by employment-based insurance: CPS 1988-1993

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

1-5 6-10 11-15 16-19 20 21-25 26-30 31-35 36-39 40 &more

Hours worked

Pe

rce

nt

ins

ure

d

HI

US

NV

MI

CA

FL


The effect of PHCA on the percent covered by non-employment based insurance: CPS 1988-1993

0.0%

10.0%

20.0%

30.0%

40.0%

1-5 6-10 11-15 16-19 20 21-25 26-30 31-35 36-39 40 &more

Hours worked

Pe

rce

nt

ins

ure

d

HI

US

NV

MI

CA

FL


Conclusion

1) PHCA increased the employer-provided health insurance coverage for full-time workers.

2) There has been changes in the distribution of health insurance by working hours.

3) Some workers who are unable to find full-time jobs with health insurance might have switched to other types of insurance.

4) Results from 88-93 are different than 94-03.


Mahalo!

This research is funded in part by U.S. Department of Health and Human Services

Health Resources & Services Administration State Planning Grant

Hawaii State Department of Health.

labor market effects of the pre-paid health care act of 1974: estimates from the cps 1988-2003

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