雇主提供的健康保险和工作流动性之间有联系吗?来自最近微数据的证据

Benjamin W. Chute, Phanindra V. Wunnava
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摘要

本研究调查了因提供雇主赞助的健康保险而导致的工作不动的普遍性和严重性,这种现象被称为“工作锁定”。利用1994年至2010年全国青年纵向调查的数据,通过测量雇主赞助的健康保险对自愿离职频率的影响来确定工作锁定。随机效应的逻辑回归估计表明,工作锁定每年减少20%的自愿工作流动率。这些结果与过去的研究一致,也得到了本文采用的两种替代识别策略的支持。我们的研究结果表明,尽管有两项主要的政策干预措施(COBRA和HIPAA)旨在缓解就业锁定效应,但就业锁定效应仍然存在,并表明人们对其原因存在根本性的误解。这两项政策都使医疗保险在雇主之间更加方便,但本文提出了一个准自然实验的证据,表明问题在于缺乏可行的替代私人医疗保险来源。在这个模型中,我们发现有证据表明,通过配偶或伴侣获得医疗保险会显著增加自愿离职率。这一发现对《患者保护和平价医疗法案》(2010年)及其催化的个人健康保险交易所的预测影响具有重大影响;这些新市场将创造风险池,为被工作束缚的个人提供雇主赞助的健康保险之外的一种可行选择,从而可能“解锁”他们。
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Is There a Link between Employer-Provided Health Insurance and Job Mobility? Evidence from Recent Micro Data
This study investigates the prevalence and severity of job immobility induced by the provision of employer-sponsored health insurance – a phenomenon known as 'job-lock'. Using data from the National Longitudinal Survey of Youth from 1994 to 2010, job-lock is identified by measuring the impact of employer-sponsored health insurance on voluntary job turnover frequency. Estimates from a logistic regression with random effects indicate that job-lock reduces voluntary job turnover by 20% per year. These results that are consistent with past research and are also supported by two alternative identification strategies employed in this paper. Our results indicate a persistence of the job-lock effect, despite two major policy interventions designed to mitigate it (COBRA and HIPAA) and signal a fundamental misunderstanding of its causes. Both policies made health insurance more portable between employers, but this paper presents evidence from a quasi-natural experiment to suggest that the problem is a lack of viable alternative private sources of health insurance. In this model, we find evidence that access to health insurance through one's spouse or partner dramatically increases voluntary job turnover. This finding has significant bearing on predicted impacts of the Patient Protection and Affordable Care Act (2010) and the individual health insurance exchanges catalyzed by it; these new markets will create risk pools that may 'unlock' a job-locked individual by providing them a viable alternative to employer-sponsored health insurance.
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