Health insurance choices in two-worker households: Determinants of double coverage

Understanding how households make health insurance choices is of critical i mportance in evaluating issues of equity and efficiency in health care mark ets. We consider a largely neglected aspect of such decision making: the de cision of families with two working spouses to obtain double coverage. Usin g data from the 1987 National Medical Expenditure Survey, we find that hous ehold decisions to obtain double coverage are especially sensitive to a cou ple's out-of-pocket premium costs. Our analysis also reveals that household s with double coverage have more generous insurance, as reflected in their higher coverage rates for specific types of benefits. We also demonstrate t hat the presence of duplicate health benefits in double-covered households is not random, possibly reflecting a systematic attempt by working spouses to obtain more extensive coverage.