{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:14:55Z","timestamp":1777932895177,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T00:00:00Z","timestamp":1729641600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Med Care Res Rev"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>Decades of research shows that small firms are much less likely to offer health insurance than large firms, but less is known about differences among small employers. We examine this issue using the Medical Expenditure Panel Survey-Insurance Component with Administrative Records (MEPS-ICAR), a unique employer-employee linked data set that is constructed by matching the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) to Internal Revenue Service administrative records and the Decennial Census. Multivariate analyses show that among firms with fewer than 50 workers, the probability that workers receive an insurance offer is positively associated with higher median workforce incomes, and conditional offers of dependent coverage increase when the majority of workers are married or from a family with at least three members. This first application of the MEPS-ICAR highlights the significance of workforce characteristics in shaping small employer insurance benefits and the data\u2019s usefulness for expanding analyses of policy changes, wage-benefit tradeoffs, and health insurance benefits.<\/jats:p>","DOI":"10.1177\/10775587241286920","type":"journal-article","created":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T12:17:28Z","timestamp":1729685848000},"page":"79-87","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["New Linked Employee-Employer Data Show Workforce Composition Is Associated With Health Insurance Offers Among Small Employers"],"prefix":"10.1177","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4830-1457","authenticated-orcid":false,"given":"Alice","family":"Zawacki","sequence":"first","affiliation":[{"name":"United States Census Bureau, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2486-6293","authenticated-orcid":false,"given":"Thomas A.","family":"Hegland","sequence":"additional","affiliation":[{"name":"Agency for Healthcare Research and Quality, Rockville, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia S.","family":"Keenan","sequence":"additional","affiliation":[{"name":"Agency for Healthcare Research and Quality, Rockville, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. Edward","family":"Miller","sequence":"additional","affiliation":[{"name":"Agency for Healthcare Research and Quality, Rockville, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,10,23]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077558704273803"},{"key":"e_1_3_3_3_1","unstructured":"Agency for Healthcare Research and Quality. (2024). Medical expenditure panel survey \u2013 Insurance component private sector data. Percent of Employees in Establishments that Offer Health Insurance. Retrieved July 2 2024 https:\/\/datatools.ahrq.gov\/meps-ic?tab=private-sector-national&dash=25"},{"key":"e_1_3_3_4_1","volume-title":"Low-wage uninsured workers: Who are they and where do they work?","author":"Alker J.","year":"2021","unstructured":"Alker J. (2021). Low-wage uninsured workers: Who are they and where do they work? Center for Children and Families, Georgetown University."},{"key":"e_1_3_3_5_1","volume-title":"Trends in small-group market health insurance, 2013-2020","author":"Banthin J.","year":"2022","unstructured":"Banthin J. (2022). Trends in small-group market health insurance, 2013-2020. The Urban Institute."},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.15620\/cdc:113097"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0047-2727(02)00191-3"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.5034\/inquiryjrnl_39.2.118"},{"key":"e_1_3_3_9_1","unstructured":"Hegland T. A. Zawacki A. Miller G. E. (2022). Introducing the medical expenditure panel survey-insurance component with administrative records (MEPS-ICAR): Description data construction methodology and quality assessment (Working Paper No. CES-22-29). Center for Economic Studies U.S. Census Bureau. https:\/\/www.census.gov\/library\/working-papers\/2022\/adrm\/CES-WP-22-29.html"},{"issue":"5","key":"e_1_3_3_10_1","first-page":"935","article-title":"To offer or not to offer: The role of price in employers\u2019 health insurance decisions","volume":"36","author":"Marquis M. S.","year":"2001","unstructured":"Marquis M. S., Long S. H. (2001). To offer or not to offer: The role of price in employers\u2019 health insurance decisions. Health Services Research, 36(5), 935\u2013958.","journal-title":"Health Services Research"},{"issue":"6","key":"e_1_3_3_11_1","first-page":"133","article-title":"Why do small firms offer health insurance in spite of the employer mandate exemption?","volume":"41","author":"Mendoza R. L.","year":"2022","unstructured":"Mendoza R. L. (2022). Why do small firms offer health insurance in spite of the employer mandate exemption? Journal of Insurance Regulation, 41(6), 133\u2013152.","journal-title":"Journal of Insurance Regulation"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.17310\/ntj.2019.1.05"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10754-016-9210-8"},{"key":"e_1_3_3_14_1","first-page":"1","volume-title":"Proceedings, Annual Conference on Taxation and Minutes of the Annual Meeting of the National Tax Association","volume":"112","author":"Minicozzi A.","year":"2019","unstructured":"Minicozzi A., Molloy E., Mortenson J., Xu L. (2019). The decision to offer health insurance: Analyzing small firms using tax data. Proceedings, Annual Conference on Taxation and Minutes of the Annual Meeting of the National Tax Association, 112, 1\u201316."},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.2307\/146416"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.13.5.149"},{"key":"e_1_3_3_17_1","volume-title":"Small employers: Their diversity and health insurance","author":"Nichols L. M.","year":"1997","unstructured":"Nichols L. M., Blumberg L. J., Acs G. P., Uccello C. E., Marsteller J. A. (1997). Small employers: Their diversity and health insurance. The Urban Institute."},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/056943450705100104"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.5034\/inquiryjrnl_44.3.257"},{"key":"e_1_3_3_20_1","volume-title":"What does the CPS tell us about health insurance coverage in 2020?","author":"Tolbert J.","year":"2021","unstructured":"Tolbert J., Orgera K., Damico A. (2021). What does the CPS tell us about health insurance coverage in 2020? Kaiser Family Foundation Data Note."},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077558711401918"},{"key":"e_1_3_3_22_1","unstructured":"Zawacki A. Taylor A. (2005). Contributions to health insurance premiums: When does the employer pay 100 percent? (Working Paper Series CES 05-27). 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