

Tracking Small-Firm Coverage, 1989-1996
January/February 1998
Health Affairs, vol.17, no.1 (January/February 1998): 167-171
Paul B. Ginsburg, Jon R. Gabel, Kelly A. Hunt
espite the fact that small employers are somewhat more willing to
offer health insurance - up from 46 percent in 1989 to 49 percent in 1996 - employees in
firms with fewer than 200 workers are increasingly unlikely to accept health insurance.
The most important factor behind declining employee enrollment may be the sharp increase
in the size of contributions required from workers. Related factors include declining real
earnings for less skilled workers and the possibility that for those with the lowest
expected use of medical care, purchasing medical care through employer-based insurance may
be more expensive than paying for it directly. The combination of more small firms
offering insurance and fewer enrolled employees in those firms results in a net decline in
the proportion of workers who have employer-provided health insurance.
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