Health Insurance Coverage among Working-Age Adults in the United States: The Role of Changes in Family Characteristics

Christine Percheski, Northwestern University

Health insurance coverage for working-age Americans has declined substantially over the past three decades, but there has been little research into how this decline relates to changes in family characteristics. Using CPS data, this paper applies two decomposition techniques (shift/share and Oaxaca-Blinder) to estimate how much of the decline in insurance rates between 1984 and 2008 can be accounted for by changes in the marital and parental status of the population. I find that declines in the percentage married explain some of the uninsurance trend, although this was offset for women by increases in employment. For young adults, family changes are associated with even larger declines in insurance rates, but this was partially offset by increased educational attainment, school enrollment, and full-time employment. Although not the main driver of uninsurance among working-age adults, changes in marital and parental status were a non-trivial factor, especially for young white men.