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Health Insurance Benefit Mandates and the Firm-Size Distribution

Author

Listed:
  • Bailey, James

    (Creighton University)

  • Webber, Douglas A.

    (Federal Reserve Board of Governors)

Abstract

By 2010, the average US state had passed 37 health insurance benefit mandates (laws requiring health insurance plans to cover certain additional services). Previous work has shown that these mandates likely increase health insurance premiums, which in turn could make it more costly for firms to compensate employees. Using 1996–2010 data from the Quarterly Census of Employment and Wages and a novel instrumental variables strategy, we show that there is limited evidence that mandates reduce employment. However, we find that mandates lead to a distortion in firm size, benefiting larger firms that are able to self-insure and thus exempt themselves from these state-level health insurance regulations. This distortion in firm size away from small businesses may lead to substantial decreases in productivity and economic growth.

Suggested Citation

  • Bailey, James & Webber, Douglas A., 2015. "Health Insurance Benefit Mandates and the Firm-Size Distribution," IZA Discussion Papers 9292, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp9292
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    References listed on IDEAS

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    1. Luis Garicano & Claire Lelarge & John Van Reenen, 2016. "Firm Size Distortions and the Productivity Distribution: Evidence from France," American Economic Review, American Economic Association, vol. 106(11), pages 3439-3479, November.
    2. Chad Syverson, 2011. "What Determines Productivity?," Journal of Economic Literature, American Economic Association, vol. 49(2), pages 326-365, June.
    3. Madrian, Brigitte & Cutler, David, 1998. "Labor Market Responses to Rising Health Insurance Costs," Scholarly Articles 2643643, Harvard University Department of Economics.
    4. Kowalski Amanda E. & Congdon William J. & Showalter Mark H., 2008. "State Health Insurance Regulations and the Price of High-Deductible Policies," Forum for Health Economics & Policy, De Gruyter, vol. 11(2), pages 1-26, November.
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    7. Joanna N. Lahey, 2012. "The efficiency of a group‐specific mandated benefit revisited: The effect of infertility mandates," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 31(1), pages 63-92, December.
    8. Jensen, Gail A & Gabel, Jon R, 1992. "State Mandated Benefits and the Small Firm's Decision to Offer Insurance," Journal of Regulatory Economics, Springer, vol. 4(4), pages 379-404, December.
    9. James Bailey, 2013. "The Effect of Health Insurance Benefit Mandates on Premiums," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 40(1), pages 119-127, December.
    10. Currie, Janet & Madrian, Brigitte C., 1999. "Health, health insurance and the labor market," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 50, pages 3309-3416, Elsevier.
    11. Aghion, Philippe & Akcigit, Ufuk & Howitt, Peter, 2014. "What Do We Learn From Schumpeterian Growth Theory?," Handbook of Economic Growth, in: Philippe Aghion & Steven Durlauf (ed.), Handbook of Economic Growth, edition 1, volume 2, chapter 0, pages 515-563, Elsevier.
    12. Feldman, Roger, 1993. "Who pays for mandated health insurance benefits?," Journal of Health Economics, Elsevier, vol. 12(3), pages 341-348, October.
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    Cited by:

    1. Yaa Akosa Antwi & Johanna Catherine Maclean, 2017. "State Health Insurance Mandates and Labor Market Outcomes: New Evidence on Old Questions," NBER Working Papers 23203, National Bureau of Economic Research, Inc.
    2. James Bailey, 2022. "State Health Insurance Benefit Mandates and Health Care Affordability," JRFM, MDPI, vol. 15(2), pages 1-10, February.
    3. Li, Xiaoxue & Ye, Jinqi, 2017. "The spillover effects of health insurance benefit mandates on public insurance coverage: Evidence from veterans," Journal of Health Economics, Elsevier, vol. 55(C), pages 45-60.

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    More about this item

    Keywords

    employment; interest groups; self-insurance; benefit mandates; health insurance; firm size;
    All these keywords.

    JEL classification:

    • L51 - Industrial Organization - - Regulation and Industrial Policy - - - Economics of Regulation
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J32 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs - - - Nonwage Labor Costs and Benefits; Retirement Plans; Private Pensions

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