Same-Sex Marriage and Gains in Employer-Sponsored Insurance for US Adults, 2008–2017

2020 ◽  
Vol 110 (4) ◽  
pp. 537-539
Author(s):  
Janelle Downing ◽  
Paulette Cha

Objectives. To estimate the effects of same-sex marriage recognition on health insurance coverage. Methods. We used 2008–2017 data from the American Community Survey that represent 18 416 674 adult respondents in the United States. We estimated changes to health insurance outcomes using state–year variation in marriage equality recognition in a difference-in-differences framework. Results. Marriage equality led to a 0.61 percentage point (P = .03) increase in employer-sponsored health insurance coverage, with similar results for men and women. Conclusions. US adults gained employer-sponsored coverage as a result of marriage equality recognition over the study period, likely because of an increase in dependent coverage for newly recognized same-sex married partners.

Demography ◽  
2021 ◽  
Author(s):  
Christopher S. Carpenter ◽  
Gilbert Gonzales ◽  
Tara McKay ◽  
Dario Sansone

Abstract A large body of research documents that the 2010 dependent coverage mandate of the U.S. Affordable Care Act was responsible for significantly increasing health insurance coverage among young adults. No prior research has examined whether sexual minority young adults also benefitted from the dependent coverage mandate despite previous studies showing lower health insurance coverage among sexual minorities. Our estimates from the American Community Survey, using difference-in-differences and event study models, show that men in same-sex couples aged 21–25 experienced a significantly greater increase in the likelihood of having any health insurance after 2010 than older, 27- to 31-year-old men in same-sex couples. This increase is concentrated among employer-sponsored insurance, and it is robust to permutations of periods and age groups. Effects for women in same-sex couples and men in different-sex couples are smaller than the associated effects for men in same-sex couples. These findings confirm the broad effects of expanded dependent coverage and suggest that eliminating the federal dependent mandate could reduce health insurance coverage among young adult sexual minorities in same-sex couples.


2021 ◽  
pp. 107755872110008
Author(s):  
Edward R. Berchick ◽  
Heide Jackson

Estimates of health insurance coverage in the United States rely on household-based surveys, and these surveys seek to improve data quality amid a changing health insurance landscape. We examine postcollection processing improvements to health insurance data in the Current Population Survey Annual Social and Economic Supplement (CPS ASEC), one of the leading sources of coverage estimates. The implementation of updated data extraction and imputation procedures in the CPS ASEC marks the second stage of a two-stage improvement and the beginning of a new time series for health insurance estimates. To evaluate these changes, we compared estimates from two files that introduce the updated processing system with two files that use the legacy system. We find that updates resulted in higher rates of health insurance coverage and lower rates of dual coverage, among other differences. These results indicate that the updated data processing improves coverage estimates and addresses previously noted limitations of the CPS ASEC.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
De-Chih Lee ◽  
Hailun Liang ◽  
Leiyu Shi

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.


2021 ◽  
pp. 107755872110158
Author(s):  
Priyanka Anand ◽  
Dora Gicheva

This article examines how the Affordable Care Act Medicaid expansions affected the sources of health insurance coverage of undergraduate students in the United States. We show that the Affordable Care Act expansions increased the Medicaid coverage of undergraduate students by 5 to 7 percentage points more in expansion states than in nonexpansion states, resulting in 17% of undergraduate students in expansion states being covered by Medicaid postexpansion (up from 9% prior to the expansion). In contrast, the growth in employer and private direct coverage was 1 to 2 percentage points lower postexpansion for students in expansion states compared with nonexpansion states. Our findings demonstrate that policy efforts to expand Medicaid eligibility have been successful in increasing the Medicaid coverage rates for undergraduate students in the United States, but there is evidence of some crowd out after the expansions—that is, some students substituted their private and employer-sponsored coverage for Medicaid.


2013 ◽  
pp. 1-7
Author(s):  
C. SIORDIA

Background:Item allocation (the assignment of plausible values to missing or illogical responses insurvey studies) is at times necessary in the production of complete data sets. In the American Community Survey(ACS), missing responses to health insurance coverage questions are allocated. Objectives:Because allocationrates may vary as a function of compositional characteristics, this project investigates how seven different healthinsurance coverage items vary in their degree of allocation along basic demographic variables. Methods: Datafrom the ACS 2010 1-year Public Use Microdata Sample file are used in a logistic regression model and tocalculate allocations rates. Results:The findings reveal that: males; people aged 65 and older; those who speakEnglish “very well” or “well”; US citizens; those out-of-poverty; and all racial/ethnic minority groups havehigher odds of experiencing a health insurance item allocation relative to their counterparts. Conclusions: Sincehealth insurance coverage allocations vary by demographic characteristics, further research is needed toinvestigate their mechanisms of missingness and how these may have implications for frailty related research.


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