The effects of recent employment changes and premium increases on adults' insurance coverage

This study uses national survey data from 1997, 1999, and 2002 to estimate a statistical model of the relationships between employment loss, insurance costs, and insurance coverage of nonelderly adults. Simulations based on the model suggest that the large increase in private insurance premiums (about 33 percent in constant dollars) was responsible for 3.1 of the 3.4 percentage-point drop in private insurance coverage between 2000 and 2003. Employment loss has a substantial impact on the coverage of people who lose employment, but its impact on aggregate coverage is relatively small. Expanded public coverage absorbed only about one quarter of the loss of private coverage. Controlling insurance (and medical) cost inflation is critical to expanding insurance coverage, even after the employment rate recovers.