1. This research is funded in part through a U.S. Health Resources and Services Administration, State Planning Grant to the Hawaii State Department of Health. Sub-Contract Research Corporation of the University of Hawaii. Research conducted by the University of Hawaii, Social Science Research Institute in collaboration with the Hawaii State Department of Health, Hawaii Institute for Public Affairs: Hawaii Uninsured Project and the Hawaii Health Information Corporation. 1 The Effect of Mandatory Employer-Sponsored Insurance (ESI) on Health Insurance Coverage and Employment in Hawai ` i: Evidence from the Current Population Survey (CPS) 1994-2003 Sang-Hyop Lee, Ph.D. Gerard Russo, Ph.D. Lawrence Nitz, Ph.D. Abdul Jabbar, Ph.D. Candidate University of Hawai`i at Mānoa Hawaii HRSA SPG Technical Workshop VI 17 September 2004

2. Preliminary results. Revised September 2004. Subject to further revision. 2 Research Questions: PHCA What is the impact of PHCA on hours worked? What is the impact of PHCA on insurance coverage?

3. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 3 Data and Method Current Population Survey (CPS) March Demographic Supplement 1994-2003 Analyze the performance of Hawaii system after implementation of the PHCA relative to the other states and US US, Hawaii, Nevada, Michigan, California, and Florida Counter-factual analysis

4. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 4 Percent Distribution of Employees by Hours Worked: CPS 1994-2003

5. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 5 Estimating the effect of PHCA Methodology: multinomial logit model Three categories: uninsured, employment based insurance, or other insurance Predictor variables: age, sex, income, working hours, ethnicity, industry of employment, and collective bargaining. Predict the effect of hours worked on probability of coverage Impact of hours worked holding other characteristics constant.

6. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 6 The effect of PHCA on the percent uninsured: CPS 1994-2003

7. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 7 The effect of PHCA on the percent covered by employment-based insurance: CPS 1994-2003

8. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 8 Predicted Probability of ESI by Hours Worked: Hawaii & US

9. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 9 Predicted Probability of ESI by Hours Worked: Hawaii & Nevada

10. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 10 Predicted Probability of ESI by Hours Worked: Hawaii & Michigan

11. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 11 The effect of PHCA on the percent covered by non-employment based insurance: CPS 1994-2003

12. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 12 Probability of Non-Employment Based Insurance by Hours Worked: Hawaii & US

13. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 13 Probability of Non-Employment Based Insurance by Hours Worked: Hawaii & Nevada

14. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 14 Probability of Non-Employment Based Insurance by Hours Worked: Hawaii & Michigan

15. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 15 Other Sensitivity Analyses 1) Regression with and without CHAMPUS/TRICARE enrollees 2) Using Hawaii means (vs. US means) => Results are qualitatively same.

16. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 16 The effect of PHCA on the percent covered by employment-based insurance without CHAMPUS/TRICARE: CPS 1994-2003

17. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 17 The effect of PHCA on the percent covered by employment-based insurance using Hawaii means: CPS 1994-2003

18. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 18 Conclusions: PHCA 1) PHCA has shifted the distribution of employees by hours worked. 2) PHCA has increased the employer-provided health insurance coverage for full-time workers. 3) PHCA has changed the distribution of health insurance by hours worked. 4) Some workers who are unable to find full-time jobs with health insurance might have switched to other types of insurance.

19. 17 September 2004Preliminary results. Revised September 2004. Subject to further revision. 19 Mahalo! This research is funded in part by U.S. Department of Health and Human Services Health Resources & Services Administration State Planning Grant Hawaii State Department of Health.