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Medical Care Research and Review
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Does Having Two Earners in the Household Matter for Understanding How Well Employer-Based Health Insurance Works?

Jean M. Abraham

University of Minnesota

Anne Beeson Royalty

Indiana University Purdue University Indianapolis

Using the 1996 Medical Expenditure Panel Survey, the authors investigate differences between households with two earners and those with a single earner in households’ access to employer-based health insurance and the generosity of insurance options. They examine whether a household has an offer of coverage, whether a household holds coverage, and whether all household members are covered. They also explore whether two-earner households have more generous options as measured by the number and types of plans available, as well as contribution requirements. The authors find that having a second earner in the household dramatically improves both access to employer health insurance and the generosity of health plan choices, particularly for workers generally acknowledged to have little access, such as part-time workers and workers in small establishments.

Key Words: Employer-based health insurance • household • access to coverage • insurance generosity • self-employed • small establishment • part-time

Medical Care Research and Review, Vol. 62, No. 2, 167-186 (2005)
DOI: 10.1177/1077558704273803
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