Increases in the cost of providing health insurance must have some effect on labor markets, either in lower wages, changes in the composition of employment, or both. Despite a presumption that most of this effect will be in the form of lower wages, we document in this paper a significant effect on work hours as well. Using data from the CPS and the SIPP, we show that rising health insurance costs over the 1980s increased the hours worked of those with health insurance by up to 3 percent. We argue that this occurs because health insurance is a fixed cost, and as it becomes more expensive to provide, firms face an incentive to substitute hours per worker for the number of workers employed.

Since 2000, premiums for employer-provided health insurance have increased by 59 percent with little corresponding increase in the generosity of coverage. The effect of this increase in costs on wages and employment will depend on workers' valuation of the benefit, the elasticities of labor supply and demand, and institutional constraints on employers' ability to lower wages. Measuring these effects is difficult, however, without a source of exogenous variation in the cost of benefits. We use variation in medical malpractice payments driven by the recent "medical malpractice crisis" to identify the causal effect of rising health insurance premiums on wages, employment, and health insurance coverage. We estimate that a 10 percent increase in health insurance premiums reduces the aggregate probability of being employed by 1.6 percent and hours worked by 1 percent, and increases the likelihood that a worker is employed only part-time by 1.9 percent. For workers covered by employer provided health insurance, this increase in premiums results in an offsetting decrease in wages of 2.3 percent. Thus, rising health insurance premiums may both increase the ranks of the unemployed and place an increasing burden on workers through decreased wages for workers with employer health insurance and decreased hours for workers moved from full time jobs with benefits to part time jobs without.

In the U.S., health insurance (HI) coverage is linked to employment in ways that can affect both wages and the demand for certain types of workers. That close linkage can also affect people¿s decisions to enter the labor force, to work fewer or more hours, to retire, and even to work in one particular job or another. This economic brief shows that the overall impact on labor markets (LM) is difficult to predict. Although economic theory and experience provide some guidance as to the effect of specific provisions, large-scale changes to the HI system could have more extensive repercussions than have previously been observed and also may involve numerous factors that would interact ¿ affecting LM in potentially offsetting ways.

The US does not have universal healthcare coverage for all its citizens. Instead, institutions have been cobbled together, with coverage varying from person to person. Some forms of health insurance are part of the compensation for employment, while others can be accessed whether the person is employed or not. Employers and the government provide most people their health insurance. The Affordable Care Act has mandated all employers with at least 50 full time employees to cover the health insurance of at least 95 percent of the employees. This coverage is borne as a cost by the employer. My thesis uses longitudinal data from the March Current Population Survey (CPS) conducted by the Census for the Bureau of Labor Statistics (which includes individual-level responses to many demographic and socioeconomic questions) to estimate the impact of insurance cost by observing two sets of time periods (before the mandate is imposed and after the mandate is imposed) to study what has been the impact on variables such as wages, for people who are the heads of their households and what the variation is based on (such as race, age, level of education, and marital status).

Who really pays for health benefits? An accessible explanation of the economic theory behind this question