Working Paper: NBER ID: w11436
Authors: Judith A. Shinogle; David S. Salkever
Abstract: Employment-based health insurance is the main source of health coverage for the non-elderly. Few previous studies have examined the factors that impact employer decision-making in selecting the coverage to offer to their employees and none have examined generosity of mental health coverage. This paper uses cross-sectional data from a survey of medium to large firms, including information on employee characteristics, to examine the empirical determinants of mental health coverage choices. We find that the firm's demand for mental health coverage is strongly influenced by employee characteristics. We also find that certain state and local policy interventions directed at enhancing access to mental health care have impacts on coverage decisions. Specifically, public provision of mental health lowers mental health coverage generosity and parity legislation increases mental health generosity. Future research with panel data is warranted to examine the causal effects of these policies.
Keywords: mental health; health benefits; employer-sponsored insurance
JEL Codes: I; I1
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| employee characteristics (M51) | mental health coverage generosity (I13) |
| percentage of female employees (J21) | mental health coverage generosity (I13) |
| presence of salaried employees (M51) | mental health coverage generosity (I13) |
| percentage of employees with heavy alcohol consumption (L66) | mental health coverage generosity (I13) |
| public provision of mental health services (I39) | mental health coverage generosity (I13) |
| parity legislation (J18) | mental health coverage for firms with fewer than 1000 employees (I13) |