@article {6488, title = {How Does Employment-Based Insurance Coverage Relate to Health After Early Retirement?}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {74}, year = {2019}, month = {2019 Sep 15}, pages = {1211-1212}, keywords = {Activities of Daily Living, Age Factors, Aged, depression, Employment, Female, Health Benefit Plans, Employee, Humans, Male, Middle Aged, Retirement, United States}, issn = {1758-5368}, doi = {10.1093/geronb/gbw020}, url = {http://psychsocgerontology.oxfordjournals.org/content/early/2016/03/17/geronb.gbw020.short}, author = {Ben Lennox Kail} } @article {7689, title = {Coverage or costs: the role of health insurance in labor market reentry among early retirees.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {67}, year = {2012}, month = {2012 Jan}, pages = {113-20}, publisher = {67B}, abstract = {

OBJECTIVES: This study evaluated the impact of insurance coverage on the odds of returning to work after early retirement and the change in insurance coverage after returning to work.

METHOD: The Health and Retirement Study was used to estimate hierarchical linear models of transitions to full-time work and part-time work relative to remaining retired. A chi-square test was also used to assess change in insurance coverage after returning to work.

RESULTS: Insurance coverage was unrelated to the odds of transitioning to full-time work. However, relative to employer-provided insurance, private nongroup insurance increased the odds of transitioning to part-time work, whereas public insurance reduced the odds of making this transition. Additionally, after returning to work, insurance coverage increased among those who were without employer-provided insurance in retirement.

DISCUSSION: Results indicated that source of coverage may be more useful in explaining returns to part-time work than simply whether people have coverage at all. In other words, the mechanism underlying the positive relationship between insurance and returning to work appeared to be limited to those who return to work because of the cost of private nongroup insurance. Among these people, however, there was some evidence that they are able to secure new coverage once they return to work.

}, keywords = {Employment, Female, Health Benefit Plans, Employee, Health Surveys, Humans, Insurance Coverage, Insurance, Health, Male, Middle Aged, Retirement, United States}, issn = {1758-5368}, doi = {10.1093/geronb/gbr130}, url = {http://proquest.umi.com.proxy.lib.umich.edu/pqdweb?did=2579962341andFmt=7andclientId=17822andRQT=309andVName=PQD}, author = {Ben Lennox Kail} } @article {7743, title = {Determinants of retirement timing expectations in the United States and Australia: a cross-national comparison of the effects of health and retirement benefit policies on retirement timing decisions.}, journal = {J Aging Soc Policy}, volume = {24}, year = {2012}, month = {2012}, pages = {291-308}, publisher = {24}, abstract = {

Data from the U.S. Health and Retirement Study (N = 2,589) and the Australian Household Income and Labour Dynamics survey (N = 1,760) were used to compare the macro-level policy frameworks on individual retirement timing expectations for pre-baby boomers (61+ years) and early baby boomers (45 to 60 years). Australian workers reported younger expected age of retirement compared to the U.S. sample. Reporting poor health was more strongly associated with younger expected retirement age in the United States than in Australia. Cohort and gender differences in the United States were found for the effect of private health insurance on younger expected age at retirement. Our results draw attention to how cross-national comparisons can inform us on the effects of policies on retirement expectations among older workers.

}, keywords = {Activities of Daily Living, Age Factors, Australia, Cross-Cultural Comparison, Florida, Health Benefit Plans, Employee, Health Status, Humans, Job Satisfaction, Middle Aged, Pensions, Public Policy, Retirement, Sex Factors, Socioeconomic factors, Time Factors, United States}, issn = {1545-0821}, doi = {10.1080/08959420.2012.676324}, author = {K. A. Sargent-Cox and Kaarin J. Anstey and Kendig, H. and Skladzien, E.} } @article {7756, title = {The effects of health shocks on employment and health insurance: the role of employer-provided health insurance.}, journal = {Int J Health Care Finance Econ}, volume = {12}, year = {2012}, month = {2012 Dec}, pages = {253-67}, abstract = {

Employment-contingent health insurance (ECHI) has been criticized for tying insurance to continued employment. Our research sheds light on two central issues regarding employment-contingent health insurance: whether such insurance "locks" people who experience a health shock into remaining at work; and whether it puts people at risk for insurance loss upon the onset of illness, because health shocks pose challenges to continued employment. We study how men{\textquoteright}s dependence on their own employer for health insurance affects labor supply responses and health insurance coverage following a health shock. We use the Health and Retirement Study (HRS) surveys from 1996 through 2008 to observe employment and health insurance status at interviews 2 years apart, and whether a health shock occurred in the intervening period between the interviews. All employed married men with health insurance either through their own employer or their spouse{\textquoteright}s employer, interviewed in at least two consecutive HRS waves with non-missing data on employment, insurance, health, demographic, and other variables, and under age 64 at the second interview are included in the study sample. We then limited the sample to men who were initially healthy. Our analytical sample consisted of 1,582 men of whom 1,379 had ECHI at the first interview, while 203 were covered by their spouse{\textquoteright}s employer. Hospitalization affected 209 men with ECHI and 36 men with spouse insurance. A new disease diagnosis was reported by 103 men with ECHI and 22 men with other insurance. There were 171 men with ECHI and 25 men with spouse employer insurance who had a self-reported health decline. Labor supply response differences associated with ECHI-with men with health shocks and ECHI more likely to continue working-appear to be driven by specific types of health shocks associated with future higher health care costs but not with immediate increases in morbidity that limit continued employment. Men with ECHI who have a self-reported health decline are significantly more likely to lose health insurance than men with insurance through a spouse. With the passage of health care reform, the tendency of men with ECHI as opposed to other sources of insurance to remain employed following a health shock may be diminished, along with the likelihood of losing health insurance.

}, keywords = {Adult, Aged, Employment, Health Benefit Plans, Employee, Health Status, Hospitalization, Humans, Longitudinal Studies, Lung Diseases, Male, Neoplasms, Occupations, Retirement, Socioeconomic factors, Spouses}, issn = {1573-6962}, doi = {10.1007/s10754-012-9113-2}, author = {Cathy J. Bradley and David Neumark and Meryl Motika} } @article {7660, title = {Dynamic Inefficiencies in an Employment-Based Health Insurance System: Theory and Evidence.}, journal = {Am Econ Rev}, volume = {101}, year = {2011}, month = {2011 Dec}, pages = {3047-77}, publisher = {101}, abstract = {

We investigate the effects of the institutional settings of the US health care system on individuals{\textquoteright} life-cycle medical expenditures. Health is a form of general human capital; labor turnover and labor-market frictions prevent an employer-employee pair from capturing the entire surplus from investment in an employee{\textquoteright}s health. Thus, the pair underinvests in health during working years, thereby increasing medical expenditures during retirement. We provide empirical evidence consistent with the comparative statics predictions of our model using the Medical Expenditure Panel Survey (MEPS) and the Health and Retirement Study (HRS). Our estimates suggest significant inefficiencies in health investment in the United States.

}, keywords = {Employment, Health Benefit Plans, Employee, Health Expenditures, Health Status, Humans, Income, Personnel Turnover, Retirement, United States}, issn = {0002-8282}, doi = {10.1257/aer.101.7.3047}, author = {Fang, H. and Alessandro Gavazza} } @article {7669, title = {How does health insurance affect the retirement behavior of women?}, journal = {Inquiry}, volume = {48}, year = {2011}, month = {2011 Spring}, pages = {51-67}, publisher = {48}, abstract = {

The availability of health insurance is a crucial factor in the retirement decision. Women are substantially less likely to have health insurance from their own employment. Using the Health and Retirement Study, we examine the role of employer-provided retiree health insurance in the retirement decisions of single women, and women in single-earner and dual-earner couples. We compare the effect of health insurance on female and male retirement. Our results show that retiree health insurance increases retirement for all groups except single men. We find suggestive evidence that the role of health insurance for women hinges on their husbands{\textquoteright} labor force status.

}, keywords = {Decision making, Female, Health Benefit Plans, Employee, Humans, Male, Models, Econometric, Multivariate Analysis, Pensions, Retirement, Spouses, United States, Women, Working}, issn = {0046-9580}, doi = {10.5034/inquiryjrnl_48.01.04}, author = {Kanika Kapur and Jeannette Rogowski} } @article {7674, title = {Who pays for obesity?}, journal = {J Econ Perspect}, volume = {25}, year = {2011}, month = {2011 Winter}, pages = {139-58}, publisher = {25}, abstract = {

Adult obesity is a growing problem. From 1962 to 2006, obesity prevalence nearly tripled to 35.1 percent of adults. The rising prevalence of obesity is not limited to a particular socioeconomic group and is not unique to the United States. Should this widespread obesity epidemic be a cause for alarm? From a personal health perspective, the answer is an emphatic "yes." But when it comes to justifications of public policy for reducing obesity, the analysis becomes more complex. A common starting point is the assertion that those who are obese impose higher health costs on the rest of the population{\textemdash}a statement which is then taken to justify public policy interventions. But the question of who pays for obesity is an empirical one, and it involves analysis of how obese people fare in labor markets and health insurance markets. We will argue that the existing literature on these topics suggests that obese people on average do bear the costs and benefits of their eating and exercise habits. We begin by estimating the lifetime costs of obesity. We then discuss the extent to which private health insurance pools together obese and thin, whether health insurance causes obesity, and whether being fat might actually cause positive externalities for those who are not obese. If public policy to reduce obesity is not justified on the grounds of external costs imposed on others, then the remaining potential justification would need to be on the basis of helping people to address problems of ignorance or self-control that lead to obesity. In the conclusion, we offer a few thoughts about some complexities of such a justification.

}, keywords = {Adult, Cost of Illness, Financing, Personal, Health Benefit Plans, Employee, Health Care Costs, health policy, Humans, Income, Insurance Coverage, Insurance Pools, Insurance, Health, Life Expectancy, Models, Econometric, Obesity, Prevalence, Private Sector, Public Sector, Risk Adjustment, Social Control Policies, United States}, issn = {0895-3309}, doi = {10.1257/jep.25.1.139}, author = {Bhattacharya, Jay and Sood, Neeraj} } @article {7310, title = {Cancer survivorship, health insurance, and employment transitions among older workers.}, journal = {Inquiry}, volume = {46}, year = {2009}, note = {PMID: 19489481}, month = {2009 Spring}, pages = {17-32}, publisher = {46}, abstract = {

This study examined the effect of job-related health insurance on employment transitions (labor force exits, reductions in hours, and job changes) of older working cancer survivors. Using multivariate models, we compared longitudinal data for the period 1997-2002 from the Penn State Cancer Survivor Study to similar data for workers with no cancer history in the Health and Retirement Study, who were also ages 55 to 64 at follow-up. The interaction of cancer survivorship with health insurance at diagnosis was negative and significant in predicting labor force exits, job changes, and transitions to part-time employment for both genders. The differential effect of job-related health insurance on the labor market dynamics of cancer survivors represents an additional component of the economic and psychosocial burden of cancer on survivors.

}, keywords = {Career Mobility, Cohort Studies, Female, Health Benefit Plans, Employee, Health Insurance Portability and Accountability Act, Humans, Longitudinal Studies, Male, Middle Aged, Models, Statistical, Neoplasms, Retirement, Survivors, United States}, issn = {0046-9580}, doi = {10.5034/inquiryjrnl_46.01.17}, author = {Tunceli, Kaan and Pamela F. Short and John R. Moran and Tunceli, Ozgur} } @article {7376, title = {Dental care coverage transitions.}, journal = {Am J Manag Care}, volume = {15}, year = {2009}, month = {2009 Oct}, pages = {729-35}, publisher = {15}, abstract = {

OBJECTIVE: To examine dental insurance transition dynamics in the context of changing employment and retirement status.

STUDY DESIGN: Data from the Health and Retirement Study (HRS) were analyzed for individuals 51 years and older between the 2004 and 2006 waves of the HRS.

METHODS: The primary focus of the analysis is the relationship between retirement and transitions in dental care coverage. We calculate and present bivariate relationships between dental coverage and retirement status transitions over time and estimate a multivariable model of dental coverage controlling for retirement and other potentially confounding covariates.

RESULTS: Older adults are likely to lose their dental coverage on entering retirement compared with those who remain in the labor force between waves of the HRS. While more than half of those persons in the youngest group (51-64 years) were covered over this entire period, two-thirds of those in the oldest group (>or=75 years) were without coverage over the same period. We observe a high percentage of older persons flowing into and out of dental coverage over the period of our study, similar to flows into and out of poverty.

CONCLUSIONS: Dental insurance is an important factor in the decision to seek dental care. Yet, no dental coverage is provided by Medicare, which provides medical insurance for almost all Americans 65 years and older. This loss of coverage could lead to distortions in the timing of when to seek care, ultimately leading to worse oral and overall health.

}, keywords = {Aged, Career Mobility, Female, Health Benefit Plans, Employee, Humans, Insurance Coverage, Insurance, Dental, Interviews as Topic, Male, Middle Aged, United States}, issn = {1936-2692}, author = {Richard J. Manski and John F Moeller and Haiyan Chen and Patricia A St Clair and Jody Schimmel and Larry S. Magder and John V Pepper} } @article {6832, title = {Breast cancer and women{\textquoteright}s labor supply.}, journal = {Health Serv Res}, volume = {37}, year = {2002}, month = {2002 Oct}, pages = {1309-28}, publisher = {37}, abstract = {

OBJECTIVE: To investigate the effect of breast cancer on women{\textquoteright}s labor supply. DATE SOURCE/STUDY SETTING: Using the 1992 Health and Retirement Study, we estimate the probability of working using probit regression and then, for women who are employed, we estimate regressions for average weekly hours worked using ordinary least squares (OLS). We control for health status by using responses to perceived health status and comorbidities. For a sample of married women, we control for spouses{\textquoteright} employer-based health insurance. We also perform additional analyses to detect selection bias in our sample.

PRINCIPAL FINDINGS: We find that the probability of breast cancer survivors working is 10 percentage points less than that for women without breast cancer. Among women who work, breast cancer survivors work approximately three more hours per week than women who do not have cancer. Results of similar magnitude persist after health status is controlled in the analysis, and although we could not definitively rule out selection bias, we could not find evidence that our results are attributable to selection bias.

CONCLUSIONS: For some women, breast cancer may impose an economic hardship because it causes them to leave theirjobs. However, for women who survive and remain working, this study failed to show a negative effect on hours worked associated with breast cancer. Perhaps the morbidity associated with certain types and stages of breast cancer and its treatment does not interfere with work.

}, keywords = {Breast Neoplasms, Comorbidity, Cost of Illness, Decision making, Employment, Family Characteristics, Female, Health Benefit Plans, Employee, Health Status, Humans, Marital Status, Middle Aged, Probability, Selection Bias, Survivors, United States, Women, Working}, issn = {0017-9124}, doi = {10.1111/1475-6773.01041}, author = {Cathy J. Bradley and Bednarek, Heather and David Neumark} } @article {6590, title = {Employee benefits, retirement patterns, and implications for increased work life.}, journal = {EBRI Issue Brief}, year = {1997}, month = {1997 Apr}, pages = {1-23}, publisher = {No. 184}, abstract = {

This Issue Brief examines why policymakers are concerned about the trend toward early retirement and how it relates to Social Security, Medicare, and employee health and retirement benefits. It reviews the rationale for the effects of economic incentives on early retirement decisions and includes a summary of empirical literature on the retirement process. It presents data on how employee benefits influence workers{\textquoteright} expected retirement patterns. Finally, it examines the implications of public policies to reverse early-retirement trends and raise the eligibility age for Social Security and Medicare. An employee Benefit Research Institute/Gallup survey indicates that there is a direct link between a worker{\textquoteright}s decision to retire early and the availability of retiree health benefits. In 1993, 61 percent of workers reported that they would not retire before becoming eligible for Medicare if their employer did not provide retiree health benefits. Participation in a pension plan can be an important determinant of retirement. Twenty-one percent of pension plan participants planned to stop working before age 65, compared with 12 percent among nonparticipants. Workers whose primary pension plan was a defined benefit plan were more likely to expect to stop working before age 65 (23 percent) than workers whose primary plan was a defined contribution plan (18 percent). Expected income replacement rates effect retirement patterns, indicating that as the expected replacement increases, the probability of expecting to stop working before age 65 increases. Twenty-two percent of workers with an expected income replacement rate below 60 percent expected to stop working before age 65, compared with 29 percent for those in the 60-69 percent replacement range, and 30 percent for those in the 70-79 percent replacement range. Workers expecting to receive retiree health insurance are more likely to expect to stop working before age 65 than workers who do not expect to have retiree health insurance. Twenty-one percent of workers with retiree health insurance expected to stop working before age 65, compared with 12 percent of workers not expecting to receive retiree health insurance. The Social Security Old-Age and Survivors Insurance (OASI) program depends on obtaining sufficient revenue from active workers{\textquoteright} payroll taxes to fund the benefits received by retired beneficiaries. Funding the program in the past was in large part effortless because of the relatively large number of workers per retiree. Today, funding the program is a greater challenge because the ratio of workers to retirees has fallen. Policymakers have been able to agree that reform of the program is necessary for its survival; however, the debate over options to reform the program is just beginning, and it is likely to be a long time before a consensus emerges.

}, keywords = {Age Factors, Aged, Employment, Female, Health Benefit Plans, Employee, Health Status Indicators, Humans, Male, Medicare, Middle Aged, Pensions, Private Sector, Retirement, Social Security, United States}, issn = {0887-137X}, url = {https://www.ncbi.nlm.nih.gov/pubmed/10166809}, author = {Fronstin, Paul} } @article {6575, title = {Health insurance coverage at midlife: characteristics, costs, and dynamics.}, journal = {Health Care Financ Rev}, volume = {18}, year = {1997}, month = {1997 Spring}, pages = {123-48}, publisher = {18}, type = {Journal}, abstract = {

Recent data from the first two waves of the Health and Retirement Study are analyzed to evaluate prevalence of different types of health insurance, characteristics of different plan types, and change sin coverage as individuals approach retirement age. Although overall rates of coverage are quite high among the middle-aged, the risk of noncoverage is high within many disadvantaged groups, including Hispanics, low-wage earners, and the recently disabled. Sixty percent of individuals with health benefits are enrolled in health maintenance organizations (HMOs) or preferred provider organizations (PPOs). In addition, one-fourth of enrollees in fee-for-service (FFS) plans report restrictions in their access to specialists.

}, keywords = {Age Factors, Costs and Cost Analysis, Demography, Female, Health Benefit Plans, Employee, Health Care Surveys, Humans, Insurance Coverage, Insurance, Health, Logistic Models, Longitudinal Studies, Male, Middle Aged, United States}, issn = {0195-8631}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194511/}, author = {Richard W. Johnson and Crystal, Stephen} }