Comparing Offers and Take-ups of Employee Health Insurance across Race, Gender, and Decade*

How often do U.S. employees receive health insurance offers from employers? When offered, how often do they take up their employer-based health insurance? This article uses the 1992 and 2002 waves of the National Study of the Changing Workforce (NSCW) to investigate changes in access to (offers) and employees electing to accept, take, or purchase their employers ’ health insurance plans (take-ups) among wage and salaried workers. Although much research has studied employee health benefits, little has examined the intersection of gender and race regarding both offers and take-ups of such benefits. Logistic regression results indicate that offers and take-ups of personal health benefits declined from 1992 to 2002, net of salient controls. Further analyses demonstrate that these declines did not affect all workers identically. Offers declined somewhat for both women and men among whites and African Americans, but declined more among Hispanic women and men. Among other ethnoracial groups, offers declined the most among men, but increased among comparable women. Take-ups declined among white men and Hispanic workers. However, white and African American women’s take-ups did not change and among African American men take-ups increased. We discuss the need to examine gender and race simultaneously and urge researchers to more closely examine changes in health benefit offers and take-ups