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October 2003
The Growing Share of Uninsured Workers Employed by Large Firms A generally unreported
phenomenon in recent years is the increasing number of U.S.
workers in large firms who lack health insurance. Although large
employers are much more likely than small ones to offer health
coverage, recent evidence suggests that large-firm workers and
their dependents comprise a significant and growing share of the
working uninsured. A combination of
factors seems to be responsible for falling health coverage rates
within large firms: the decline in manufacturing jobs and
unionization rates, restrictions placed on benefit eligibility and
higher employee premium contributions, as well as service industry
trends and the changing structure of large corporations. Because
it is likely to persist, this trend has important implications for
policies designed to reduce the number of uninsured Americans.

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