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The near elderly are a vulnerable population group, with expected high medical expenditures. Unless blind or disabled, they do not qualify for public insurance (Medicare or Medicaid), and options for purchase of health insurance in private individual markets are equally restricted. Preexisting conditions may be excluded, and some persons in poor health are not insurable at all. For those who are insurable, premium costs in individual markets may be prohibitively high. Older workers contemplating early retirement must therefore rely primarily on employment-based health insurance until they are eligible for Medicare. This study considers how older workers' retirement behavior is affected by access to employment-based health insurance policy initiatives, including continuation and portability mandates and changes in the way firms must account for retiree health benefits in earnings statements. A discussion of the effects of other policy changes is also provided to create a framework in which future policy options may be evaluated.

Originally published in: Health Benefits and the Workforce, Washington, D.C.: U.S. Dept. of Labor, Pension and Welfare Benefits Administration, 1998, pp. 43-71.

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