Health Insurance, Pensions, and Paid Leave: Access to Health Insurance at Small Firms in a Broader Benefit Context: Working Paper 2007-08

Workers employed at small firms are substantially less likely to be offered health insurance than those at larger firms. Policymakers and researchers have long sought ways to increase access to employer insurance for workers at small firms but with little success. Most policy proposals and reforms—for example, the small group insurance reforms enacted by many states in the 1990s—have been directed specifically toward health insurance and based on the assumption that the firm-size “offer gap” in health insurance is caused by problems unique to such insurance. Yet there may be an even more