Graduation to Health Insurance Coverage: 1981-1996

entrants, provides an early indicator of the strengths and weaknesses of the employer-sponsored health insurance system. Insurance coverage for these men has fallen sharply over the past 15 years. We examine patterns of health insurance coverage for cohorts of young men using successive cross-sectional surveys and longitudinal data. We find that coverage declines persist and are exacerbated as young men age. Not only did cohorts of men born during the 1950s fail to age into employer-sponsored coverage as they reached their 30s and 40s, they actually lost such coverage as they grew older. Furthermore, young men who lacked coverage when they were in their mid-20s were unlikely to gain such coverage later. Declines in coverage are sharpest among the least educated cohorts of young men. We show that most of this decline was due to the substantial increase in health insurance costs during the 1980s. By contrasting young men's pension receipt experience with their health insurance experience, we show that structural changes in the labor market cannot explain any of the decline in coverage within cohorts. Our results suggest that the existing system of employer-sponsored health insurance subsidies did not compensate for the declines in earnings and increases in health insurance costs faced by young men between 1981 and 1996.