Cover: Employment Change and Continuation of Health Insurance Coverage

Employment Change and Continuation of Health Insurance Coverage

Published 2004

by Jacob Alex Klerman, Omar Rahman

Purchase Print Copy

Add to Cart Paperback12 pages Free

Most health insurance coverage in the U.S. is tied to an employment relation. This institutional arrangement poses special problems for job losers and job changers. Using data from the Survey of Income and Program Participation (SIPP), this study, in six sections: (1) examines the dynamic link between employment and health insurance, looking at Consolidated Omnibus Budget Reconciliation Act (COBRA) and COBRA-like coverage from several different angles; (2) provides an overview of levels and trends of health insurance coverage in the U.S. and their link to the employment relation; (3) describes the SIPP data; (4) examines the potential efficacy of COBRA coverage for solving the problem of the uninsured in the U.S. today; (5) examines recent reports that only about ten percent of COBRA eligible workers purchase the coverage; and (6) uses the data to compare the levels of coverage for job leavers before and after the implementation of the legislation. The results suggest that the non-employed are less likely to be covered by health insurance than the employed. The problem is especially concentrated among the unemployed (a small share of the non-employed). Nevertheless, continuation coverage is unlikely to have a major effect on the levels of non-coverage.

Originally published in: Health Benefits and the Workforce, 1992, pp. 93-104.

This report is part of the RAND reprint series. The Reprint was a product of RAND from 1992 to 2011 that represented previously published journal articles, book chapters, and reports with the permission of the publisher. RAND reprints were formally reviewed in accordance with the publisher's editorial policy and compliant with RAND's rigorous quality assurance standards for quality and objectivity. For select current RAND journal articles, see External Publications.

This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.