International Journal of Health Care Finance and Economics

, Volume 11, Issue 1, pp 55–81

Premium growth and its effect on employer-sponsored insurance


DOI: 10.1007/s10754-011-9088-4

Cite this article as:
Vistnes, J. & Selden, T. Int J Health Care Finance Econ (2011) 11: 55. doi:10.1007/s10754-011-9088-4


We use variation in premium inflation and general inflation across geographic areas to identify the effects of downward nominal wage rigidity on employers’ health insurance decisions. Using employer level data from the 2000 to 2005 Medical Expenditure Panel Survey-Insurance Component, we examine the effect of premium growth on the likelihood that an employer offers insurance, eligibility rates among employees, continuous measures of employee premium contributions for both single and family coverage, and deductibles. We find that small, low-wage employers are less likely to offer health insurance in response to increased premium inflation, and if they do offer coverage they increase employee contributions and deductible levels. In contrast, larger, low-wage employers maintain their offers of coverage, but reduce eligibility for such coverage. They also increase employee contributions for single and family coverage, but not deductibles. Among high-wage employers, all but the largest increase deductibles in response to cost pressures.


Employer-sponsored health insurancePremium growthEmployer decisions

JEL Classification


Copyright information

© Springer Science+Business Media, LLC (outside the USA)  2011

Authors and Affiliations

  1. 1.Center for Financing, Access and Cost TrendsAgency for Healthcare Research and QualityRockvilleUSA