Stefani Portillo

Major and Classification

Public Policy Analysis, with minors in Economics and Applied Analytics

Faculty Mentor

Mark Philips


USC Sol Price School of Public Policy

Research Gateway Project

Employer Sponsored Insurance: How ESI Influences Vulnerable Populations

Project Abstract

Employer sponsored insurance (ESI)–fully or partially covered insurance plans offered by an employer as an additional benefit–is the dominant form of health coverage in the United States with around 60% of the general population obtaining coverage through ESI. However, ESI has faced several criticisms, most significantly concerning job lock. “Job lock,” also known as job immobility, occurs when employees stay in jobs to retain health coverage despite wanting to leave. Much of the research on this phenomenon emphasizes business effects, such as level of productivity and efficiency in the workplace. However, the risks job lock may present for vulnerable workers–those who are low income, already have health problems, have few alternatives to their current coverage through ESI, or would have little access to ESI at other jobs in their sector– have largely gone unstudied. Using data from the 2015 American Working Conditions Survey (AWCS), this research project conducted several linear probability models to further understand the relationship between ESI and vulnerable workers. Holding all other variables constant, the analyses identified that someone who is experiencing stress (discrimination, harassment, or abuse) in the workplace is 11.6 percentage points more likely to be looking for another job and someone who is satisfied with their job is 33.0 percentage points less likely. At the same time, however, someone who is in poor health and receives ESI is 30.8-32.4 percentage points less likely to be looking for another job. The results of the analyses imply that those in poor health are more likely to experience job lock despite added stress factors (discrimination, harassment, or abuse) and may present added concerns to an insurance system dominated by ESI.