RESEARCH

IN ACTION

Agency for Healthcare Research and Quality • www.ahrq.gov

Introduction

For decades, Federal and State policymakers have sought

ways to offer affordable health insurance coverage, but this

goal has been elusive. The number of uninsured remains

high and costs for health care insurance keep growing, even

though legislation has been enacted and regulatory changes

have been made that affect both public and private programs.

The U.S. employer-based health insurance market provides

insurance coverage to nearly two-thirds of the population

under 65. In addition, nearly 80 percent of the uninsured

live in a family where at least one adult is employed

Therefore, building on these programs might be an attractive

component of any solution. But it is essential to have sound,

evidence-based information about that system to make

informed decisions. This Research in Action is intended to

answer questions that might arise during discussions about

options. Based on data obtained by the Federal Agency for

Healthcare Research and Quality (AHRQ) in the Medical

Expenditure Panel Survey (MEPS), an ongoing series of

annual surveys, it answers the questions—

• What are the recent trends in offer, eligibility, and

enrollment rates? 

• What impact does firm size have on whether or not

employers offer health insurance? 

• What factors affect whether employees enroll in

insurance programs? 

• Who is less likely to have employer-sponsored

insurance? 

Background

Having health insurance is valuable for a number of

reasons. People who are insured are protected against

uncertain and high medical expenses and are more likely to

receive needed and appropriate health care. In addition,

having health insurance is associated with improved health

outcomes and lower mortality, so employees with health

insurance are more likely to be productive workers.1

Employer-Sponsored Health Insurance: Trends in Cost and Access

Making a Difference

Offer rates have risen while eligibility and enrollment

rates have declined...Page 2

Cost is a major reason for declining enrollment...Page 3

Larger firms are more likely to offer insurance...Page 4

Low-wage workers are more sensitive to the size of the

employee premium contribution...Page 5

Hispanics, young adults, near-elderly, working women

with health problems are more likely to be

uninsured...Page 5

Issue #17 September 2004

Author: Mark W. Stanton, M.A.

Managing Editor: Margaret Rutherford

Design and Production: Joel Boches

Suggested citation: Stanton MW, Rutherford MK. Employer-sponsored health insurance: trends in cost and access. Rockville (MD): Agency for Healthcare Research

and Quality; 2004. Research in Action Issue 17. AHRQ Pub. No. 04-0085.

Advancing Excellence in Health Care
In the first half of 2003, the U.S. employer-based health

insurance market provided insurance to over 159 million

Americans who constitute nearly two-thirds (63.4 percent)

of the population under 65.2 In this voluntary system,

employers may choose whether to offer health insurance to

their employees and employees may choose to enroll or

forgo enrollment. Most employers have chosen to offer

health insurance as a fringe benefit to attract employees. It

is an attractive option to offer because of the favorable tax

treatment to both employer and employee. In addition,

employment-based health insurance is likely to be less

expensive than individually purchased coverage (for the

same set of benefits) and typically provides a broader scope

of benefits than is available in individually purchased

coverage. The stability of the employer-sponsored insurance

system is supported by a tax subsidy that promotes the

pooling of risk necessary for the successful functioning of

insurance.3,4

When an employer offers health insurance to its employees,

usually some conditions are attached, such as a waiting

period before benefits take effect for new employees, a

requirement that the employee be full time or work a

specified number of hours per week, and a requirement that

employees pay a portion of the premium. Small employers

with predominantly low-wage workers are much less likely

to offer health insurance since the greater cost of

underwriting and administering coverage for each enrollee

in a small workforce adds to the cost of the premium.

Since smaller firms face higher rates of employee turnover,

it is likely that a smaller percentage of their workers will

fulfill the waiting period required for enrollment. Also,

since small businesses experience higher rates of business

failure than larger firms do, they have greater incentives to

keep their costs of doing business low.5 Finally, the lack of

coverage at such firms may reflect the weaker preferences

of small-firm employees for compensation in the form of

health insurance benefits compared to wage income.6

The system of employer-sponsored health insurance has

long provided coverage to the vast majority of America’s

workers and their dependents. Many of the rest are insured

through public programs such as Medicaid and the State

Children’s Health Insurance Program (SCHIP) or through

privately purchased insurance in the individual market. Yet

there remains a sizable group of workers and their

dependents who are uninsured. Persons who are uninsured

over the long term experience poorer health and earlier

death than the insured population, and it is estimated that

such problems are associated with societal costs ranging

from $65 billion to $130 billion per year.

7

Factors affecting insurance trends

What are the recent trends in offer, eligibility, and

enrollment rates?

In recent years (1996-2002), countervailing trends among

offer, eligibility, and enrollment rates have characterized the

employer-sponsored health insurance market. Offer rates

have risen while eligibility and enrollment rates have gone

down, whether measured in relation to all private-sector

2 www.ahrq.gov

The Medical Expenditure Panel Survey

AHRQ’s Medical Expenditure Panel Survey (MEPS) is

an ongoing series of annual surveys designed to

continually provide policymakers, health care

administrators, businesses, and others with timely,

comprehensive information about health care use and

costs in the United States and to improve the accuracy of

their economic projections. As a health care survey,

MEPS emphasizes and provides a broad range of

estimates on insurance status. Its utility as a natural

benchmark has been reinforced by the adoption of

MEPS premium cost estimates in the Gross Domestic

Product. MEPS is unique in its ability to link data on

individuals and households (including demographics,

health status, employment, and income) to information

on their use of health care. No other survey contains such

a wide range of data essential for analyzing health

spending and insurance coverage.

For purposes of this synthesis, the household and

insurance components of MEPS are especially important

since they offer detailed statistical information on many

health-insurance-related questions. In 2003, the MEPSHC (Household Component) surveyed 15,000 families

including 37,000 individuals; it has had a response rate

of over 70 percent. The MEPS-IC (Insurance

Component) surveys 42,000 business establishments and

governments and has a response rate of 78 percent. For

more information, see the MEPS Web site at:

http://www.ahrq.gov/data/mepsix.htm
employees, private-sector full-time employees, or privatesector part-time employees (Table 1). For example, from

1996 to 2002, among all private-sector employees, the offer

rate increased from 86.5 percent to 88.3 percent, the

eligibility rate decreased from 81.3 percent to 77.1 percent,

and the enrollment rate dropped from 69.6 percent to 62.4

percent. In addition, the enrollment-when-eligible rate

dropped 4.5 percentage points, from 85.5 percent in 1996

to 81.0 percent in 2001.8 Some of the decrease in the

enrollment rate may result from an increase in workers who

enroll in their spouse’s employer-sponsored plans instead of

their own. One study reporting on a drop in enrollment in

the period 1987-96 found that it was partly offset by a

rising rate of enrollment in a spouse’s plan.6

According to recent research, the principal reason for

decreasing enrollment during the period 1987-2000 was

that the cost to employees had risen substantially.9 An

earlier analysis of enrollment trends in the period 1987-96

www.ahrq.gov 3

Definitions 

The offer rate is the percent of employees who work where insurance is offered. 

The eligibility rate is the percent of employees eligible to enroll where insurance is offered. In most cases, to be eligible for

employer-based coverage, employees must have full-time status and also pass through a waiting period after commencement

of employment. 

The enrollment rate is the percent of all who work where insurance is offered who enroll.

The enrollment-when-eligible rate is the percent of eligible workers who enroll in offered coverage.

Note: Definitions are taken from the MEPS-IC (Insurance Component).

Table 1. Offer, eligibility, and enrollment rates among private-sector employees, 1996-2002

Private-sector employees 1996 2002 Percent change

All employees

Offer 86.5 88.3 +1.8

Eligibility 81.3 77.1 -4.2

Enrollment 69.6 62.4 -7.2

Enrollment-when-eligiblea

85.5 81.0 -4.5

Full-time employees

Offer 89.9 91.3 +1.4

Eligibility 89.7 87.3 -2.4 

Enrollment 77.9 72.6 -5.3

Enrollment-when-eligible 86.9 83.1 -3.8

Part-time employees

Offer 71.2 76.5 +5.3

Eligibility 33.6 28.1 -5.5

Enrollment 21.5 14.2 -7.3

Enrollment-when-eligible 64.0 50.7 -13.3

a

Ratio of the enrollment rate to the eligibility rate.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality. Health Insurance Component Analytical Tool (MEPSnet/IC) {online database}. 

Web site: http://www.meps.ahrq.gov/mepsnet/IC/MEPSnetIC.asp. Accessed Aug. 4, 2004.
4 www.ahrq.gov

suggested that decreasing enrollments have resulted from a

variety of factors, including increasing costs of insurance,

rising employee share of health insurance premium cost,

expansions in Medicaid, declining real incomes, and

increased price-consciousness among workers.6

What is the impact of firm size on offer rates?

Firms with large numbers of employees are more likely to

offer their employees health insurance.

• Among medium and large private-sector employers

(firms with 50 or more employees), 97.8 percent of all

employees worked where health insurance was offered

in 2002.10

• Among small private-sector employers (firms with

fewer than 50 employees), 63.5 percent of all employees

worked where health insurance was offered.11

Small employers not offering health insurance typically cite

the cost of insurance and the belief that employees have

other sources of coverage (e.g., through a spouse) as their

principal reasons (Figure 1). The firms least likely to offer

coverage are those with low-wage workers, high turnover,

no unions, and many part-time employees.12 The smaller

the firm size, the more likely are its employees to be

uninsured. However, it is interesting to note that the

proportion of uninsured workers employed even by quite

large firms (500 or more workers) has grown in recent

years. Between 1987 and 2001, the proportion of

uninsured workers in these firms expanded from 25 to 32

percent. Declines in manufacturing jobs and unionization

rates are the most important reasons for the rise in

uninsured workers at these large firms.12

What factors affect whether employees enroll in

insurance?

Many factors affect whether or not employees enroll in a

health insurance plan. Employees who enroll are more

likely to be male, work full time, belong to a union, and

work in public administration or the public sector. Married

workers with or without children are less likely to enroll

than unmarried workers since, in many cases, married

people have the option of being covered under a spouse’s

policy. Two important factors affecting enrollment are the

size of the employee premium contribution and the wage

level of the workers. 

Premium contributions 

In general, the higher the employee contribution is, the less

likely employees are to enroll. 

• In 1999, employers offering a plan without employee

contributions had an enrollment rate of 87.3 percent;

employers requiring an employee premium contribution

had an enrollment rate of 77.0 percent.13

• Between 1996 and 2002, the average employee premium

contribution per enrolled private-sector employee for

single coverage rose 65.2% percent, from $342 to $565.8

• In the same period, the average employee premium

contribution per enrolled private-sector employee for

family coverage rose 55.8 percent, from $1,275 to

$1,987.8

• In 2002, the average employee premium contribution

per enrolled employee for single coverage was 19.0

percent lower in small firms than in large firms.14

• However, the average employee premium contribution

per enrolled employee for family or employee-plus-one

coverage was over 10 percent higher in small firms than

in large firms.14

Small firms (fewer than

50 employees) Medium and large firms(50 or more employees)

0

10

20

30

40

50

60

70

80

90

100

Less than 10 10-24 25-49 50-99

0

5

10

15

20

25

30

35

30%

22%

18%

14%

63.5%

97.8%

Number of workers in establishment

Figure 1. Offer rates by firm size: United States, 2002

Source: Sommers J. Employer-sponsored health insurance for small employers in the

private sector, by industry classification: 2002; Employer-sponsored health insurance for

large employers in the private sector, by industry classification: 2002. Rockville (MD):

Agency for Healthcare Research and Quality; 2003. Statistical Briefs 46 and 47. Web site:

http://www.meps.ahrq.gov/PrintProducts/. Accessed Aug. 4, 2004.
www.ahrq.gov 5

In an AHRQ study, a model was developed to examine the

influence of out-of-pocket contributions, total premiums,

and employer and workforce characteristics on workers’

enrollment decisions. The researchers estimated that

eliminating employee premium contributions had the

potential to reduce the rate of employees declining coverage

by almost a fifth. If the cost to employees of single

coverage were to fall to zero, 18.1 percent, or 2.5 million of

the 13.8 million private-sector employees who currently

decline insurance coverage from their employers, might

enroll in such insurance. Using a statistical model, the

researchers also found that the take-up rate with coverage at

no cost to employees in predominantly low-wage

establishments would increase by almost 10 percentage

points, compared to an increase of 3.9 percentage points in

predominantly high-wage establishments.13

Wage levels

Although people insured through their employment are

relatively less sensitive to premium size than those in the

individual market since they pay only a fraction of the full

premium, low-wage workers are more sensitive to the size

of the contribution than are higher income workers.15

• During 2002, 63.5 percent of employees in

predominantly low-wage establishments (50 percent or

more of employees earn less than $9.50 per hour) were

enrolled in a health insurance plan.

• In establishments in which less than 50 percent of

employees earned less than $9.50 per hour, 83 percent

of workers were enrolled in a health insurance plan.8

Who is less likely to have employer-sponsored

insurance?

In the first half of 2002, 60 percent of uninsured adults and

75 percent of uninsured children lived in a family with at

least one adult full-time worker.16 Groups less likely to

have employer-sponsored insurance include workers in

small establishments, minorities (especially Hispanic

males), young adults (19-24), near-elderly working women

with health problems, and retirees.a In fact, as the

establishment size increases, the percentage of uninsured

workers drops (Figure 2). Other groups less likely to be

insured are the self-employed, low-wage workers,

nonunionized workers, and part-time workers.

Small firms (fewer than 50 employees) Medium and large firms

(50 or more employees)

10

20

30

40

50

60

70

80

90

100

Less than 10 10-24 25-49 50-99 100-499 500 or more

10

15

20

25

30

35

30%

22%

18%

14%

9%

6%

63.5%

97.8%

Number of workers in establishment

Figure 2. Percent uninsured for wage earners ages 16-64 by size of establishment: United States, first half of 2003

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality. MEPS HC-064: 2003 P7R3/P8R1 Population Characteristics. Web site:

http://www.meps.ahrq.gov/Puf/PufDetail.asp. Forthcoming.

Note: An establishment refers to a particular workplace or location.

a

An establishment refers to a particular workplace or location. A firm

(the entire company) consists of one or more establishments under

common ownership or control. A large firm may have many small

establishments.
6 www.ahrq.gov

Hispanics

Declining enrollment rates for Hispanic workers are

increasing the disparity in Hispanic-white coverage rates,

according to an AHRQ study.17 Between 1987 and 1996,

no change was observed in the large differential in health

insurance coverage between most minority groups and

white Americans, except for Hispanic men, where this

differential widened. The most important factors

contributing to this widening gap between minorities and

whites were a declining union membership rate and a

greater likelihood among non-elderly American workers of

being in a poor or low-income household. Among nonelderly American workers: 

• Employment-related insurance coverage among

Hispanic men declined 13.0 percentage points between

1987 and 1996.

• The decline among Hispanic and black women was 7

percentage points, while the decline was less than 3

percentage points for white men.18

• By 2003, 38.5 percent of Hispanic males under 65 were

uninsured, compared to 16.2 percent of white males.19

Young adults, near-elderly working women, retirees 

Young adults and near-elderly working women with health

problems were other groups less likely to have employersponsored insurance and more likely to be uninsured.

Although most retirees are eligible for Medicare, they are

becoming less likely to receive employer-sponsored retiree

health benefits. 

Young adults ages 19-24 were the age group most likely to

be uninsured, with 36.3 percent uninsured for all or part of

2003, according to MEPS data.20 At age 19, most young

adults who do not go to college are dropped from their

parents’ insurance coverage. In making the transition to

work, many young adults are in low-wage or temporary

jobs where health insurance is not offered. If they are from

low-income families (below 200 percent of Federal poverty

level), they are much more likely to be uninsured.20

In 1996, near-elderly working women (ages 55-64) with

health problems, a group comprising 1.8 million persons,

were at much greater risk of being uninsured (22.7 percent)

than their counterparts in very good or excellent health (9.5

percent). Although near-elderly workers were more likely

than prime-age workers (30-54) to purchase coverage

outside the workplace, there has been a decline in private

coverage purchased outside the workplace by women in this

age group. Factors associated with the greater likelihood of

near-elderly women with health problems being uninsured

appear to be lower income and less access to jobs offering

insurance.21

The availability of employer-sponsored health insurance for

retirees is shrinking.b The availability of employersponsored health insurance is much broader for current fulltime employees than for retirees and varies by economic

sector and size of the employer. With the exception of large

governments, the percent of full-time employees who

worked where health insurance was offered to retirees fell

from 1998 to 2000.22

The decrease in the offer rate to retirees varied by size of

firm. For retirees age 65 and over, from 1998 to 2002:

• Among firms with less than 50 employees, the

availability of retiree coverage declined from 5.6 percent

to 2.1 percent. 

• Among firms with 100 to 999 employees, the decrease

was from 18.7 percent to 9.2 percent.

• Among firms with 1,000 or more employees, the

decrease (from 41.2 percent to 41.1 percent) was not

significant.8

Effects of small group insurance reforms 

Beginning in the early 1990s, a number of States passed

legislation to enhance the availability and affordability of

health insurance to employees of firms with fewer than 50

employees. These reforms included provisions to guarantee

the issuance and renewal of health plans, to diminish

premium variability and rates of growth across small

employer groups, to limit the use of pre-existing condition

exclusions, and to enhance portability of coverage. A study

of the impact of these reforms using data from the 1987

National Medical Expenditure Survey (NMES) and 

1996-97 MEPS found that the reforms had little impact on

offer rates and enrollment rates. However, the study found

that in States with the most stringent reform, employmentrelated coverage increased for high-risk workers relative to

low-risk workers.23

b

Retirees typically are insured by Medicare but about half of people 65

and over also have supplemental insurance through their former

employers or through the private individual market.
www.ahrq.gov 7

Conclusion 

America’s employer-sponsored health insurance system

continues to provide health insurance to the vast majority of

workers and their families. However, significant numbers

of Americans lack access to coverage through the

employment-based system. Ongoing increases in health

care costs, the attendant increases in health insurance

premiums, and the rise in employee contributions for

coverage pose challenges for employers who are deciding

whether to provide such coverage and for employees who

are considering whether to enroll in coverage offered by

their employers. The information presented here highlights

some of these challenges and is intended to provide

employers and policymakers with objective information to

use as they address these difficult problems. 

This article briefly summarizes findings from MEPS on

employer-sponsored insurance that has resulted from

research conducted to date. Work on these issues is

ongoing, however, and additional information will continue

to be released as it becomes available. 

MEPS data and research publications

MEPS disseminates its health care data and publications in

a variety of formats.

• Public use files can be–

– Downloaded from the MEPS Web site:

http://www.meps.ahrq.gov/.

– Ordered from AHRQ as diskettes (floppy disks) or

CD-ROMs. 

Web site: http://www.meps.ahrq.gov/

Data_Public.htm.

• Tabulated data can be–

– Reviewed on MEPS Web sites:

http://www.meps.ahrq.gov/Data_Pub/IC_TOC.htm

or http://www.meps.ahrq.gov/

CompendiumTables/TC_TOC.htm.

– Customized via an online analytical tool called

MEPSNet. Web site: http://www.meps.ahrq.gov/

MEPSNet. This approach allows users with only

limited programming resources to use MEPS data.

• MEPS publications—

– Are available on the MEPS Web site to be viewed

online or printed as PDF files.

– Can be searched through the MEPS Publications

Database (Web site: http://www.meps.ahrq.gov/

PrintProducts/PrintProdSearch.asp), which allows

searching for specific publications and sorting of

results by various options.

• MEPS research done by outside researchers—

– May be available as reprints through the AHRQ Web

site: www.ahrq.gov.

– May be viewable through MEDLINE® or other

publication databases of the National Library of

Medicine®: http://www.nlm.nih.gov/.
8 www.ahrq.gov

References

*1. Eisenberg J, Power EJ. Transforming insurance coverage

in quality health care. Voltage drops from potential to

delivered quality. JAMA 2000; 284:2100-7.

*2. Center for Financing, Access, and Cost Trends, Agency

for Healthcare Research and Quality. MEPS HC-064:

2003 P7R3/P8R1 Population Characteristics. Web site:

<http://www.meps.ahrq.gov/Puf/PufDetail.asp.>

Forthcoming.

*3. Bernard D, Selden TM. Employer offers, private

coverage, and the tax subsidy for health insurance:1987-

1996. Int J Health Care Finance Econ 2003; 2:297-318.

*4. Monheit AC, Nichols LM, Selden TM. How are net

health insurance benefits distributed in the employmentrelated insurance market? Inquiry Winter 1995-96;

32(4):379-91.

5. Lee J. Are health insurance premiums higher for small

firms? The Synthesis Project. The Robert Wood

Johnson Foundation; Sept 2002. Research Synthesis

Report No. 2. 

*6. Cooper PF, Schone BS. More offers, fewer takers for

employment-based health insurance: 1987 and 1996.

Health Aff 1997; 16(6):142-9. 

7. Institute of Medicine, Board on Health Care Services,

Committee on the Consequences of Uninsurance.

Hidden costs, values lost: uninsurance in America.

Washington (DC): The National Academies Press; 2003.

Web site: www.nap.edu. Accessed Aug 4, 2004.

*8. Center for Financing, Access, and Cost Trends, Agency

for Healthcare Research and Quality. MEPSnet/IC

[online database]. Web site: http://www.meps.ahrq.gov/

mepsnet/IC/MEPSnetIC.asp. Accessed Jan 21, 2004.

9. Cutler D. Employee costs and the decline in health

insurance coverage. In D Cutler and A Garber, eds.

Frontiers in health policy research, volume 6.

Cambridge (MA): MIT Press; 2003.

*10. Sommers J. Employer-sponsored health insurance for

large employers in the private sector, by industry

classification: 2000. Rockville (MD): Agency for

Healthcare Research and Quality; 2003. Statistical Brief

No. 47. Web site: http://www.meps.ahrq.gov/

PrintProducts/. Accessed Aug 4, 2004. 

*11. Sommers J. Employer-sponsored health insurance for

small employers in the private sector, by industry

classification: 2002. Rockville (MD): Agency for

Healthcare Research and Quality; 2003. Statistical Brief 

No. 46. Web site: http://www.meps.ahrq.gov/

PrintProducts/. Accessed Aug 4, 2004. 

12. Glied S, Lambrew JM, Little S.The growing share of

uninsured workers employed by large firms.

Commonwealth Fund; Oct 2003. 

*13. Cooper PF, Vistnes J. Workers’ decisions to take-up

offered health insurance coverage: assessing the

importance of out-of-pocket premium costs. Med Care

2003; 41(7 Suppl):III35-43.

*14. Branscome JM. Employer-sponsored single, employeeplus-one, and family health insurance coverage:

selection and cost, 2001. Rockville (MD): Agency for

Healthcare Research and Quality; 2004. Statistical Brief

No. 50. Web site: http://www.meps.ahrq.gov/

PrintProducts/. Accessed Aug 4, 2004.

*15. Blumberg LJ, Nichols LM, Banthin JS. Worker

decisions to purchase health insurance. Int J Health

Care Finance Econ 2001; 1:305-25.

*16. Hudson J. The uninsured in America, first half of 2002:

estimates of the uninsured living in working families for

the civilian noninstitutionalized population under age

65. Rockville (MD): Agency for Healthcare Research

and Quality; 2004. Statistical Brief No. 39. Web site:

http://www.meps.ahrq.gov/PrintProducts/. 

Accessed Aug 4, 2004.

*17. Monheit AC, Vistnes JP. Race/ethnicity and health

insurance status: 1987 and 1996. Med Care Research

Rev 2000; 57(1 Suppl):11-35.

*18. Rhoades J, Chu M. Health insurance status of the

civilian noninstitutionalized population: 1999. Rockville

(MD): Agency for Healthcare Research and Quality;

2000. MEPS Research Findings No.14. AHRQ Pub. No.

01-0011.

*19. Center for Financing, Access, and Cost Trends, Agency

for Healthcare Research and Quality. MEPS HC-064:

2003 P7R3/P8R1 Population characteristics. Web site:

http://www.meps.ahrq.gov/Puf/PufDetail.asp. 

Accessed Aug 24, 2004.

20. Collins SR, Schoen C, Tenney K, et al. Rite of passage?

Why young adults become uninsured and how new

policies can help. Commonwealth Fund; May 2003.

Issue Brief. Web site: http://www.cmwf.org/. 

Accessed Oct 8, 2003.

*21. Monheit AC, Vistnes JP, Eisenberg JM. Moving to

Medicare: trends in the health insurance status of nearelderly workers, 1987-1996. Health Aff 2001; 20(2):

204-13.

*AHRQ funded/sponsored research
*22. Sommers J. Employer sponsored health insurance for

full time employees and retirees: 1998 and 2000.

Rockville (MD): Agency for Healthcare Research and

Quality; 2003. Statistical Brief No. 17. Web site:

http://www.meps.ahrq.gov/PrintProducts/. 

Accessed Aug 4, 2004. 

*23. Monheit AC, Schone BS. How has small group market

reform affected employee health insurance coverage? J

Public Econ 2004; 88:237-54.

*AHRQ funded/sponsored research

www.ahrq.gov 9

www.ahrq.gov 11

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