Prior research indicates that rural workers are less likely than urban workers to obtain health insurance coverage through their employers. The reasons for this differential in coverage rates are not well understood. This study uses data from the 1993 Robert Wood Johnson Foundation Employer Health Insurance Survey to measure differences in the proportion of rural and urban workers who are offered insurance coverage, in their participation rates in offered plans, to assess the effects of firm size, wages, and other factors in explaining residential differences. Offer rates and participation rates are both lower in rural areas, but the probability of employer-based coverage among rural workers rises to that of urban workers when rural firm size and wages are adjusted to urban levels. Rural firms and workers are not behaviorally different from urban firms and workers--just at a greater disadvantage because of their smaller size and lower wages
Originally published in: Medical Care Research and Review, v. 55, no. 4, pp. 484-496.
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