Chronic Illness and Health Insurance-Related Job Lock

We examine job duration patterns for evidence of health insurance-related job lock among chronically ill workers or workers with a chronically ill family member. Using Cox proportional hazard models, we allow for more general insurance effects than in the existing literature to indicate the impact of health insurance and health status on workers' job durations. We use data for workers in Indiana predating the Health Insurance Portability and Accountability Act (HIPAA) to examine the potential impact of HIPAA on job mobility. Chronic illness reduced job mobility by about 40 percent among the workers in our sample who relied on their employers for coverage as compared to otherwise similar workers who did not rely on their employers for coverage. Our results identify previously underappreciated job lock among chronically ill workers and workers with a chronically ill family member, clarify how one best researches job lock, and indicate the potential impact of policies aimed at alleviating job lock and promoting inter-employer worker mobility. This paper was revised August 2000.