Disparities In Employer-Sponsored Health Insurance, Property Tax Exemption For Health Care Nonprofits

ROCHESTER, NY (11/08/2007)(readMedia)-- More than 27 million working Americans aged 19 to 64 have no health insurance -- and many of these uninsured are disproportionately Hispanics, African Americans and immigrants. Two research articles in INQUIRY’s fall issue (Vol. 44, No. 3) examine the disparities in employer-sponsored insurance (ESI) among racial and ethnic minorities.

“Why Do Hispanics Have So Little Employer-Sponsored Health Insurance?” by James D. Reschovsky, Jack Hadley, and Len Nichols -- This study found that the ability to speak English is a major indicator of whether Hispanics have ESI. Using data from the Community Tracking Study Household Survey, the study looked at the questions of why Hispanics’ ESI coverage is so much lower than that of whites, and why the rapid growth in the Hispanic population hasn’t broadened that gap. The researchers found that English-speaking Hispanics are more similar to whites in labor market experiences and employer health coverage than they are to Spanish-speaking Hispanics. Poor education, lack of citizenship and the inability to speak English---all more common among Spanish speakers---result in lower wages and fewer jobs that offer ESI, the researchers note. Spanish-speaking Hispanics also appear more sensitive to out-of-pocket premium costs and less likely to take up insurance when offered. “Our results suggest that an important policy lever for closing the ESI coverage gap is to increase Hispanic workers’ human capital through both job and English language training,” the authors conclude. “English proficiency would improve labor market opportunities, presumably lead to increased incomes, and accelerate acculturation generally.”

“The Relative Importance of Worker, Firm, and Market Characteristics for Racial/Ethnic Disparities in Employer-Sponsored Health Insurance” by Jennifer Haas and Katherine Swartz – This study, which examined whether disparities in ESI among minority groups are due to discrimination or other factors, found that worker and firm characteristics have a much greater effect on the likelihood that an individual has ESI than do local labor market conditions. According to the more complex of two estimated models, African Americans and Hispanics are more likely to be uninsured because they either work for firms that do not offer ESI or they decline coverage when it is offered. However, the authors say, the impact of race/ethnicity on having ESI is relatively small, outweighed by such factors as having a post-secondary education, being a salaried employee, and working in a larger firm or particular industry. “The results imply that public policies are needed to provide health insurance to low-income workers, who also are disproportionately less educated, recent immigrants, and African Americans and Hispanics,” the authors conclude.

Other fall research papers:

“Individual Health Insurance within the Family: Can Subsidies Promote Family Coverage?” by Kanika Kapur, José J. Escarce, and M. Susan Marquis -- This study found that premium subsidies for individual health insurance would increase family coverage. However, effects would be small, considering the costs of implementing the policy.

“Effects of Specialty Hospitals on the Financial Performance of General Hospitals, 1997-2004,” by John E. Schneider, Robert L. Ohsfeldt, Michael A. Morrisey, Pengxiang Li, Thomas R. Miller, and Bennet A. Zelner – Contrary to conjecture that the presence of specialty hospitals erodes the overall operating profits of general hospitals, this analysis found that general hospitals located in markets with at least one specialty hospital have lower costs and higher profit margins than those not competing with specialty hospitals.

“Hospital Inefficiency: What is the Impact of Membership in Different Types of Systems?” by Michael D. Rosko, Jose Proenca, Jacqueline S. Zinn, and Gloria J. Bazzoli – Results of this study showed that hospitals belonging to independent health systems displayed increased cost inefficiency; membership in centralized physician/insurance health systems and decentralized health systems was associated with the highest levels of efficiency.

“Genetic Discrimination in Health Insurance: Current Legal Protections and Industry Practices,” by Karen Pollitz, Beth N. Peshkin, Eliza Bangit, and Kevin Lucia – This paper describes a study of medical underwriting practices in the individual health insurance market related to genetic information. In seven of the 92 hypothetical decisions, underwriters said they would deny coverage, place a surcharge on premiums, or limit covered benefits based on an applicant’s genetic information.

Other features in the fall issue:

“Dialogue: The Future of Property Tax Exemption for Nonprofit Health Care Organizations” with Evelyn Brody, Doug Hammer, Oliver Henkel, Patsy Matheny, Alan R. Morse and Bruce McPherson. (Article available at http://www.inquiryjournalonline.org/inqronline/?request=get-document&issn=0046-9580&vol ume=044&issue=03&page=0238 )

“Commentary: How Much is Enough? An Evidence-Based Framework for Setting Medicaid Payment Rates,” Kevin Quinn

“The View from Here: Education Policy is Health Policy,” by INQUIRY Editor Alan Monheit (Article available at http://www.inquiryjournalonline.org/inqronline/?request=get-document&issn=0046-9580&vol ume=044&issue=03&page=0233 )

INQUIRY is a peer-reviewed scholarly publication. Now in its 44th year, it is published quarterly by Excellus Health Plan, Inc. Press releases and article abstracts are available at http://www.inquiryjournal.org/.

CONTACTS: Kevin Kane, APR, (585) 399-6635 kevin.kane@excellus.com or Ronny Frishman, (585) 264-9122 frishman@rochester.rr.com, both for INQUIRY journal; SOURCE: INQUIRY journal http://www.inquiryjournal.org/

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