Transcript Hawaii ESI MEPS 2001

Hawai`i Employer
Sponsored Health
Insurance: MEPS-IC 2003
Health Resources and Services Administration
State Planning Grant
8th Technical Workshop
Monday, January 30, 2006
Gerard Russo
Associate Professor of Economics
University of Hawaii
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
OVERVIEW OF RESULTS:
MEPS-IC 2003




Average Premiums are Lower in Hawaii than
USA overall.
PHCA seems to affect small firms and firms
with low-wage workers the most.
PHCA also seems to impact the single
premium split more than the family split.
PLEASE NOTE: Part-time and Full-time is
not specifically defined.
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
2
Health Insurance Premiums:
MEPS-IC









Medical Expenditure Panel Survey (MEPS)
Insurance Component (IC)
Agency for Healthcare Research & Quality (AHRQ)
www.ahrq.gov
Internal Revenue Service (IRS) Sampling Frame
Data Tabulated by AHRQ for the State of Hawaii
Employer Sponsored Insurance (ESI)
www.meps.ahrq.gov
James M. Branscome <[email protected]>
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
3
Internet Citations: MEPS-IC 2003

Agency for Healthcare Research and Quality. 2003 Employer-Sponsored Health
Insurance Data. Private-Sector Data by Firm Size and State (Table II
Series). Published July 2005.
http://www.meps.ahrq.gov/MEPSDATA/ic/2003/Index203.htm

Agency for Healthcare Research and Quality. 2003 Employer-Sponsored Health
Insurance Data. Private-Sector Data by Industry Groupings and State (Table V Series).
Published July 2005. http://www.meps.ahrq.gov/MEPSDATA/ic/2003/Index503.htm

Agency for Healthcare Research and Quality. 2003 Employer-Sponsored Health
Insurance Data. Private-Sector Data by Ownership Type and Age of Firm and State
(Table VI Series). Published July
2005. http://www.meps.ahrq.gov/MEPSDATA/ic/2003/Index603.htm

Agency for Healthcare Research and Quality 2003 Employer-Sponsored Health
Insurance Data. Private-Sector Data by Proportion of Employees Who Are Full-time or
Low-wage and State (Table VII Series). Published July
2005.http://www.meps.ahrq.gov/MEPSDATA/ic/2003/Index703.htm

Agency for Healthcare Research and Quality 2003 Employer-Sponsored Health
Insurance Data. Private-Sector Data by Average Wage Quartiles and State (Table VIII
Series). Published July
2005. http://www.meps.ahrq.gov/MEPSDATA/ic/2003/Index803.htm
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
4
Average Family Premiums, MEPSIC: Hawaii and US 1996-2003
Year
Hawaii
US
1996
$5,319.26
$4,953.68
1997
$5,337.13
$5,332.29
1998
$6,696.91a
$5,590.41
1999
$5,539.34
$6,058.12
2000
$6,391.68
$6,772.47
2001
$7,405.92
$7,508.94
2002
2003
$7,768.24
$7,886.84
$8,469.01
$9,248.92
aNote:
The 1998 MEPS-IC sample for Hawaii is too small to compute reliable estimates.
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
5
Average Single Premiums, MEPS-IC:
Hawaii and US 1996-2003
Year
1996
Hawaii
$2,005.45
US
$1,991.64
1997
$2,021.94
$2,050.82
1998
$2,583.84a
$2,174.35
1999
$2,207.89
$2,324.76
2000
$2,747.87
$2,654.67
2001
$2,698.29
$2,889.19
2002
$2,722.89
$3,188.90
2003
$3,019.83
$3,481.22
aNote:
The 1998 MEPS-IC sample for Hawaii is too small to compute reliable estimates.
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
6
Simple Annual Premium Growth
Model:
UH Non-Linear Discrete-Time
Estimation
Pt  P0  1  g 
t
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
7
Estimated Annual Nominal
Growth Rates: 1996-2003
UH Non-Linear Discrete-Time Estimates
 Family
Premiums
Hawaii
 US

 Single
Premiums
Hawaii
 US

6.27%
9.93%
5.57%
9.14%
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
8
Average Family Premiums in
Hawaii and US: 1996-2003 MEPS-IC
Actual, 2004-2006 UH Projection
Year
Hawaii-Actual
US-Actual
Hawaii-Predicted US-Predicted
1996
5319.26
4953.68
5237.57
4725.72
1997
5337.13
5332.29
5565.93
5195.17
1998
6696.91
5590.41
5914.89
5711.25
1999
5539.34
6058.12
6285.72
6278.61
2000
6391.68
6772.47
6679.80
6902.32
2001
7405.92
7508.94
7098.58
7587.99
2002
7768.24
8469.01
7543.62
8341.78
2003
7886.84
9248.92
8016.57
9170.45
2004
8519.16
10081.44
2005
9053.27
11082.92
2006
9620.85
12183.89
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
9
Family Premium Trend Line:
Hawaii and US 1996-2006
University of Hawaii Estimates
14000
12000
10000
8000
6000
4000
Hawaii
US
HI-Predicted
US-Predicted
2000
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
0
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
10
Average Single Premiums in Hawaii
and US: 1996-2003 MEPS-IC Actual,
2004-2006 UH Projection
Year
Hawaii-Actual
US-Actual
Hawaii-Predicted
US-Predicted
1996
2005.45
1991.64
2053.18
1872.06
1997
2021.94
2050.82
2167.53
2043.12
1998
2583.84
2174.35
2288.25
2229.81
1999
2207.89
2324.76
2415.69
2433.56
2000
2747.87
2654.67
2550.23
2655.93
2001
2698.29
2889.19
2692.26
2898.61
2002
2722.89
3188.9
2842.20
3163.47
2003
3019.83
3481.22
3000.50
3452.54
2004
3167.60
3768.02
2005
3344.02
4112.32
2006
3530.26
4488.09
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
11
Single Premium Trend Line:
Hawaii and US 1996-2006
University of Hawaii Estimates
Hawaii
US
HI-Predicted
US-Predicted
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
5000
4500
4000
3500
3000
2500
2000
1500
1000
500
0
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
12
Private Sector Family Premiums by Firm
Size: Hawaii and United States 2003
$10,000 9,387 9,340 9,233
9,375 9,038
9,286
8,111
7,878
7,860
7,264
$8,000
$6,000
$4,000
$2,000
$0
less
than 10
10 to 24 25 to 99 100 to
999
1000 or
more
Number of Employees
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
13
Employee Contributions as a Percent
of Family Premiums by Firm Size:
Hawaii and United States 2003
50%
40%
30%
20%
41.5%
42.1%
28.8%
21.8% 18.7%
31.1% 28.4%
27.5%
26.0%
22.3% 24.7%
20.2%
10%
0%
less
than 10
10 to
24
25 to
99
100 to
999
1000 or
more
Total
Number of Employees
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
14
Private Sector Single Premiums by Firm
Size: Hawaii and United States 2003,
ESI
4,500
$3,834
4,000 $3,745
$3,568
$3,470
$3,430
$3,430
$3,352
3,500
$2,880
$2,849
$2,742
3,000
2,500
2,000
1,500
1,000
500
0
less than
10
10 to 24
25 to 99
100 to
999
1000 or
more
Number of Employees
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
15
Employee Contributions as a Percent
of Single Coverage Premiums by Firm
Size: Hawaii and United States 2003
18.4%
20%
15%
10%
17.7%
15.1%
18.4%
17.4%
15.0%
12.4%
3.3%
5%
0%
less
than 10
8.3%
8.2%
7.6%
3.4%
Number of Employees
10 to
24
25 to
99
100 to
999
1000 or
more
Total
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
16
Percent of Private Establishments that
Offer Health Insurance by Firm Size:
Hawaii and United States 2003
120%
100%
80% 74.6%
60%
40%
99.9%
100.0% 99.8%
98.6%
93.5%
86.2%
81.0%
66.2%
56.2%
99.1%
35.6%
20%
0%
less
than 10
Number of Employees
10 to
24
25 to
99
100 to 1000 or
999
more
Total
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
17
Number of Employees Part-time and
Full-time by Average Wage of Work
Force: Hawaii 2003
Average Wage
l
ta
o
T
IV
e
il
rt
Q
u
a
rt
a
u
Q
Q
u
a
rt
il
il
e
e
II
II
I
e
il
rt
a
u
Q
I
353,283
400000
350000
300000
250000
Full-Time
200000
98,616
Part-Time
150000 68,502 88,359 97,806
82,586
100000
39,579 20,412
50000
11,261 11,333
0
Note: Part-time refers to no specific
number of hours.
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
18
Percent of Private Establishments that
Offer Health Insurance by Average Wage
of Work Force: Hawaii and United States
2003
120%
100.0%
100%
80%
77.8%
88.2%
59.1%
60%
40%
90.2%
72.0%
86.2%
79.7%
56.2%
39.0%
20%
0%
Quartile I Quartile
II
Quartile
III
Quartile
IV
Total
Average Wage
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
19
Percent of Full-time Employees Enrolled in
Health Insurance at Establishments that offer
Health Insurance by Average Wage of Work
Force: Hawaii and United States 2003
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
82.9%
66.0%
74.4%69.5%
79.3% 82.1%
77.0%
55.2%
Quartile I
Quartile II
Quartile III
Quartile IV
Average Wage
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
20
Percent of Part-time Employees Enrolled in
Health Insurance at Establishments that offer
Health Insurance by Average Wage of Work
Force: Hawaii and United States 2003
60%
48.1%
50%
40%
30%
35.2%
27.4%
19.4%
20%
10%
41.1%
26.1%
34.4%
26.9%
15.3%
7.4%
0%
Quartile I Quartile
II
Quartile
III
Quartile
IV
Total
Average Wage
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
21
Distribution of Employees working at
Establishments that offer Health Insurance by
Firm Size: Hawaii 2003
Firm Size
(employees)
Employees that
work where
insurance is
offered.
Employees that
work where
insurance is not
offered.
Less than 10
42,887
6,629
10-24
53,994
962
25-99
64,415
0
100-999
105,455
1,291
1000 or more
158,984
1,252
Total
425,735
10,134
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
22
Distribution of Payroll at All Establishments
by Firm Size: Hawaii 2003 (dollars)
Firm Size
(employees)
Payroll
for all
Establishments
Payroll for
Establishments
that offer Health
Insurance
Payroll for
Establishments
that do not offer
Health Insurance
Less than 10
1,265,257,725
1,092,648,400
172,609,326
10-24
1,368,665,986
1,358,339,479
10,326,507
25-99
1,946,817,568
1,946,817,568
0
100-999
3,806,235,068
3,753,791,453
52,443,615
1000 or more
5,456,796,811
5,449,961,511
6,835,300
13,843,773,158 13,601,558,411
242,214,747
Total
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
23
Distribution of Enrolled Employees working at
Establishments that offer Health Insurance by
Firm Size: Hawaii 2003
Firm Size
(employees)
Employees that
work where
insurance is
offered.
Employees that are
enrolled in health
insurance at these
establishments.
Less than 10
42,887
29,249
10-24
53,994
38,808
25-99
64,415
46,376
100-999
105,455
71,154
1000 or more
158,984
107,942
Total
425,735
293,529
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
24
Distribution of Total Premiums at
Establishments that offer Health Insurance
by Firm Size: Hawaii 2003 (dollars)
Firm Size
(employees)
Total Premium
Costs
Employer
Contribution
Employee
Contribution
Less than 10
151,917,046
119,818,913
32,098,133
10-24
170,403,908
153,680,122
16,723,785
25-99
189,191,543
148,558,741
40,632,801
100-999
322,843,953
256,663,424
66,180,529
1000 or more
544,948,420
444,655,537
100,292,883
1,379,304,869
1,123,376,738
255,928,132
Total
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
25
Total Premiums as a Percent of Payroll at
Establishments that offer Health Insurance
by Firm Size: Hawaii 2003 (dollars)
Firm Size
(employees)
Percent of
Payroll
Employer
Contribution
Employee
Contribution
Less than 10
13.9%
11.0%
2.9%
10-24
12.5%
11.3%
1.2%
25-99
9.7%
7.6%
2.1%
100-999
8.6%
6.8%
1.8%
1000 or more
10.0%
8.2%
1.8%
Total
10.1%
8.3%
1.9%
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
26
Summary



Average ESI Premiums are lower in Hawaii than
USA overall.
PHCA seems to affect small firms and firms with
low-wage workers the most.
Low-Wage Part-Time Workers are Less Likely to be
Covered by Employer-Sponsored Health Insurance.
Possible Reasons Why?




Tax benefits are less.
Premiums as a proportion of total compensation are more.
Minimum wage law prevents cash wages from adjusting
downward.
PHCA also seems to impact the single premium split
more than the family split.
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost
Trends, Medical Expenditure Panel Survey-Insurance Component.
27