Health insurance enrollment decisions: Preferences for coverage, worker sorting, and insurance take-up

Abstract

The weak response by the uninsured to initiatives encouraging voluntary enrollment in health insurance has raised concerns regarding the extent to which the uninsured value insurance. This concern is also relevant for proposals to mandate health insurance coverage since workers will suffer welfare losses if compelled to purchase coverage they perceive to be of little value. To address this issue, we use the 2001 Medical Expenditure Panel Survey to examine decisions by single workers to seek out and enroll in employer-sponsored insurance. We find that single workers with weak or uncertain preferences for health insurance are less likely to have jobs that offer coverage or to enroll in coverage when offered. Our results suggest a dual approach to expanding coverage that includes both subsidies and educational efforts regarding the value of health insurance. © 2008 Excellus Health Plan, Inc.