Union Effects on Health Insurance Provision and Coverage in the United States


Thomas C. Buchmueller

John DiNardo

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2000-04 | April 1, 2000

Since Freeman and Medoff’s (1984) comprehensive review of what unions do, union density in the U.S. has fallen substantially. During the same period, employer provision of health insurance has undergone substantial changes in extent and form. Using individual data from various supplements to the Current Population Survey and establishment data from the 1993 Robert Wood Johnson Foundation survey, we investigate the effects of unionization on employer provision of health benefits. We find that in addition to increasing coverage by employer-provided health benefits, unions reduce employee cost sharing and substantially increase the probability that employer-provided health plans extend to retirees. The union effects on coverage for current employees and for retirees have risen over time, and our estimates suggest that declining unionization explains about 17-20 percent of the decrease in employer-provided health insurance between 1983 and 1997.

Article Citation

DiNardo, John, Robert G. Valletta, and Thomas C. Buchmueller. 2000. “Union Effects on Health Insurance Provision and Coverage in the United States,” Federal Reserve Bank of San Francisco Working Paper 2000-04. Available at https://doi.org/10.24148/wp2000-04

About the Author
Robert G. Valletta
Robert G. Valletta is senior vice president and associate director of research in the Economic Research Department of the Federal Reserve Bank of San Francisco. Learn more about Robert G. Valletta