The effect of employment status on private health insurance coverage: 1977 and 1987

Analyzing cross‐sectional data from the National Medical Expenditure Survey (NMES), we find that the predicted probability of private insurance coverage for low‐income individuals as a group fell dramatically from 1977 to 1987. The results of a decompositional technique show that the relationship between full‐time employment and private insurance has weakened over the period for low‐income females, but has strengthened for males in this group. While it appears that low‐income females benefit from part‐time employment relative to their unemployed cohorts, no discernible difference is found in the likelihood of being covered by private insurance for part‐time and unemployed males. Finally, evidence suggesting a weakening over time in the relationship between part‐time employment and private insurance coverage is found among middle‐income females and high‐income males. From a policy perspective, passage of the Health Insurance Portability and Accountability Act of 1996 has taken an important first step in attempting to lower the number of uninsured, especially among full‐time workers. Our findings, however, suggest that this legislation may be too limited in scope to effectively reach part‐time workers presently uninsured. © 1998 John Wiley & Sons, Ltd.