Duke 2008 | ASHE | Equity and Efficiency in Health and Healthcare

This project uses the 1999 to 2005 Medical Expenditure Panel Survey (MEPS) to assess how access to fringe benefits such as paid sick leave and employer-sponsored insurance coverage has been changing for low-income working families during the first half of this decade. We examine whether trends in access to benefits vary with the characteristics of the family (i.e., part-time work status, race/ethnicity, education, and income level) and characteristics of parents' employers (i.e. establishment size and industry.) We explore the underlying correlates of change, examining changing offer rates within parents' industry, establishment size, union status, and demographic composition (i.e. age, race, income).

Preliminary analysis of our longitudinal MEPS sample shows offer rates for low-income families with children are eroding significantly faster than that of higher income families. While low-income families have significantly lower rates of access to paid sick leave than higher income families, it does not appear that access to sick leave has eroded over time in a similar manner as ESI offer rates. Access to these benefits for low-income families has changed differentially across industries.

We find that low-income families are not only less likely to have access to ESI, they are also increasingly less likely to take-up the benefit when offered, suggesting that low-income families may find rising ESI premiums increasingly unaffordable compared to their higher income co-workers.

Using the Oaxaca-Blinder decomposition technique, we examine the components of these changing offer and take-up rates among low-income families to examine the relative importance of changes in employment characteristics (i.e. industries, shifts in employment, and between full- and part-time work), and other socio-economic and demographic changes.