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美国税务数据中的雇主提供型健康保险保费与收入

Employer-sponsored health insurance premiums and income in U.S. tax data
Journal of Public Economics · 2023 · Ithai Z. Lurie、Corbin Miller

中文摘要

仅凭调查数据很难全面刻画美国雇主提供型健康保险保费的分布。我们利用行政税务数据绘制了总体保费分布,并就保费与包括收入在内的人口统计特征之间的关系提供了新证据。税务数据所测得的保费分布与调查数据具有可比性。收入较高的人更有可能持有雇主提供型保险(ESI)保单;在持有保单的条件下,他们也会选择价格更高的保险计划。由于高收入投保人及其雇主在ESI上的支出更多,他们获得的政府健康保险补贴也不成比例地更多;即便我们将通过联邦医疗保险、医疗补助和保费税收抵免提供的非ESI补贴纳入考量,结论依然如此。尽管健康保险补贴的分布向高收入人群倾斜,但其不平等程度尚不及收入本身分布不平等程度的四分之一。

Abstract

The distribution of employer-sponsored health insurance premiums in the United States is difficult to fully characterize with survey data. Using administrative tax data, we plot the population distribution of premiums and provide new evidence about the relationship between premiums and demographic characteristics, including income. The distribution of premiums measured in the tax data is comparable to survey data. People with higher incomes are more likely to have an employer-sponsored insurance (ESI) policy and, conditional on having a policy, select more expensive plans. Because higher income policyholders and their employers spend more on ESI, they also receive a disproportionate amount of government subsidies for health insurance, even when we account for non-ESI subsidies through Medicare, Medicaid, and Premium Tax Credits. Even though the distribution of health subsidies is skewed toward those with higher incomes, it is less than a quarter as unequal as the distribution of income itself.
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