Transcript
Page 1: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

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. Sub-Contract Research Corporation of the University of Hawaii. 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.1

The Effect of MandatoryEmployer-Sponsored Insurance (ESI)

on Health Insurance Coverage and Employment in Hawai`i:

Evidence from the Current Population Survey (CPS) 1994-2003

Sang-Hyop Lee, Ph.D.Gerard Russo, Ph.D.Lawrence Nitz, Ph.D.

Abdul Jabbar, Ph.D. CandidateUniversity of Hawai`i at Mānoa

Hawaii HRSA SPGTechnical Workshop VI

17 September 2004

Page 2: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 2

Research Questions: PHCA

What is the impact of PHCA on hours worked?

What is the impact of PHCA on insurance coverage?

Page 3: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 3

Data and Method

Current Population Survey (CPS) March Demographic Supplement 1994-2003

Analyze the performance of Hawaii system after implementation of the PHCA relative to the other states and US

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

Counter-factual analysis

Page 4: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 4

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

Page 5: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 5

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 of coverage

Impact of hours worked holding other characteristics constant.

Page 6: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 6

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

Per

cen

t u

nin

sure

d HI

US

NV

MI

CA

FL

Page 7: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 7

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

Page 8: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 8

Predicted Probability of ESI by Hours Worked: Hawaii & US

Predicted Probability of Employment-Based Health Insurance by Hours Worked (single hours), 1994-2003 CPS.

0.4

0.5

0.6

0.7

0.8

0.9

1

1 8 15 22 29 36 43 50 57 64 71 78 85

Hawaii

US

hours worked

Page 9: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 9

Predicted Probability of ESI by Hours Worked: Hawaii & Nevada

Predicted Probability of Employment-Based Health Insurance by Hours Worked (single hours), 1994-2003 CPS.

0.4

0.5

0.6

0.7

0.8

0.9

1

1 8 15 22 29 36 43 50 57 64 71 78 85

Hawaii

Nevada

hours worked

Page 10: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 10

Predicted Probability of ESI by Hours Worked: Hawaii & Michigan

Predicted Probability of Employment-Based Health Insurance by Hours Worked (single hours), 1994-2003 CPS.

0.4

0.5

0.6

0.7

0.8

0.9

1

1 8 15 22 29 36 43 50 57 64 71 78 85

Hawaii

Michigan

hours worked

Page 11: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 11

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

Per

cen

t in

sure

d HI

US

NV

MI

CA

FL

Page 12: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 12

Probability of Non-Employment Based Insurance by Hours Worked: Hawaii & US

Predicted Probabilty of Non-Employment Based Health Insuranceby Hours Worked (single hours), CPS 1994-2003.

-0.05

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

1 8 15 22 29 36 43 50 57 64 71 78 85

Hours Worked

Hawaii

US

Page 13: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 13

Probability of Non-Employment Based Insurance by Hours Worked: Hawaii & Nevada

Predicted Probabilty of Non-Employment Based Health Insuranceby Hours Worked (single hours), CPS 1994-2003.

-0.05

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

1 8 15 22 29 36 43 50 57 64 71 78 85

Hours Worked

Hawaii

Nevada

Page 14: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 14

Probability of Non-Employment Based Insurance by Hours Worked: Hawaii & Michigan

Predicted Probabilty of Non-Employment Based Health Insuranceby Hours Worked (single hours), CPS 1994-2003.

-0.05

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

1 8 15 22 29 36 43 50 57 64 71 78 85

Hours Worked

Hawaii

Michigan

Page 15: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 15

Other Sensitivity Analyses

1) Regression with and without CHAMPUS/TRICARE enrollees

2) Using Hawaii means (vs. US means)

=> Results are qualitatively same.

Page 16: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 16

The effect of PHCA on the percent covered by employment-based insurance without CHAMPUS/TRICARE: 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+

Hours worked

Per

cen

t in

sure

d

HI

US

NV

MI

CA

FL

Page 17: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 17

The effect of PHCA on the percent covered by employment-based insurance using Hawaii means: 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+

Hours worked

Per

cen

t in

sure

d

HI

US

NV

MI

CA

FL

Page 18: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 18

Conclusions: PHCA

1) PHCA has shifted the distribution of employees by hours worked.

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

3) PHCA has changed the distribution of health insurance by hours worked.

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

Page 19: Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate

17 September 2004 Preliminary results. Revised September 2004. Subject to further revision. 19

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.


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