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United States Small Business Administration
Office of Advocacy
RS 146
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Purpose
Growing dissatisfaction with current methods of financing health care and increasing concern about the size of the uninsured population have led to proposals for substantial revisions to the health care system. Many of these proposals could have differential impacts on small businesses. Measuring firm size differences in health insurance coverage is an important part of assessing the effects of health care reform on small business.
The objective of this study was to estimate the extent of health insurance coverage - and, conversely, non-coverage - among the U.S. population, with a focus on analyzing the uninsured by firm size and employment status.
This study: (1) evaluates alternative data sources that can be
used to produce estimates of the number of the uninsured by firm
size, and (2) focuses on the March Current Population Surveys
from 1988 to 1992 to obtain estimates of the insured and uninsured
by firm size and economic and demographic characteristics.
Scope and Methodology
Two major data sources, the Current Population Survey (CPS) and the Survey of Income and Program Participation (SIPP), are appropriate for estimating the number and extent of the uninsured by employment status and firm size. Both are available from the U.S. Department of Commerce, Bureau of the Census.
Overall, the CPS is better suited for a detailed analysis of the uninsured because it is a larger sample and is available on an annual basis - i.e., the March CPS. In the March CPS, the health insurance questions determine whether an individual has had coverage from various sources at any time during the previous year. In addition, the March CPS has included firm size information since 1988, permitting estimates of insurance coverage by firm size and employment status over an extended period.
The March CPS also contains demographic information such as age, gender, race, marital status, education attainment and family structure. Economic and labor force data include industry, occupation, class of worker, work experience and income.
The study examined the sources of health insurance coverage including
direct employer-provided coverage, coverage by other's employer
and non-employer coverage. The study also analyzed the size of
firm from which individuals received indirect coverage, i.e.,
coverage from a family member's employer.
Highlights
Between 1988 and 1992 the number of uninsured in the United States increased from 31.0 million to 35.5 million people. In 1992, almost 21 million (about 60 percent) of the uninsured were working. Also in 1992, 16.4 percent of private, non-agricultural wage-and-salary workers lacked health insurance.
Ordering Information
The complete report is available from:
National Technical Information Service
U.S. Department of Commerce
5285 Port Royal Road
Springfield, VA 22161
(703) 487-4650
(703) 487-4639 (TDD)
Order Number: PB94-195153
Cost: Pending
*Last Modified 6-11-01