Access to health insurance is one of the critical aspects of securing employment for people with disabilities. This study investigated whether vocational rehabilitation consumers secured employment with an employer who offered health insurance at similar rates to workers in the general population. In general, the results show that vocational rehabilitation consumers had significantly lower health insurance access rates than workers in the general population. Implications for rehabilitation counselors are discussed.
Abelson, R. ( 2007, December 19). Insurers seek bigger reach in coverage. Available January 10, 2008, from http://www.nytimes.com
2.
Are you really covered? (2007, September). Consumer Reports. Available January 13, 2008, from http://www.consumerreports.org
3.
Beatty, P., Hagglund, K., Neri, M., Dhont, K., Clark, M., & Hilton, S. ( 2003). Access to health care services among people with chronic or disabling conditions: Patterns and predictors. Archives of Physical Medicine and Rehabilitation, 84, 1417-1425.
4.
Blau, G., Merriman, K., Tatum, D., & Rudman, S. ( 2001). Antecedents and consequences of basic versus career enrichment benefit satisfaction. Journal of Organizational Behavior, 22, 669-688.
5.
Budetti, J., Shikles, J., Duchon, L., & Schoen, C. ( 1999). Can’t afford to get sick: A reality for millions of working Americans: The Commonwealth Fund 1999 National Survey of Workers’ Health Insurance. Available June 26, 2002, from http://www.cmfw.org
6.
Cohen, J. ( 1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum. Cunningham , P. (2007). Overburdened and overwhelmed: The struggles of communities with high medical cost burdens (Pub. No. 1073). New York: The Commonwealth Fund.
7.
Doty, M., Edwards, J., & Holmgren, A. ( 2005). Seeing red: Americans driven into debt by medical bills (Pub. No. 873) . New York: The Commonwealth Fund.
8.
Duchon, L., Schoen, C., Simantov, E., Davis, K., & An, C. ( 2000). Listening to workers: Challenges employer-sponsored coverage in the 21st century. Retrieved June 26, 2002, from http://www.cmfw.org
9.
Gilbride, D., Thomas, J., & Stensrud, R. ( 1998). Beyond status code 26: Development of an instrument to measure the quality of placements in the state-federal program. Journal of Applied Rehabilitation Counseling, 29(1), 3-7.
10.
Golden, T. ( 1998). Promoting career development and pursuit of employment . Journal of Applied Rehabilitation Counseling, 29(4), 4.
11.
Hadley, J. ( 2003). Sicker and poorer-The consequences of being uninsured: A review of the research on the relationship between health insurance, medical care use, health, work, and income. Medical Care Research and Review, 60(June Suppl.), 3S-75S.
12.
Hanson, K., Neuman, P., Dutwin, D., & Kasper, J. ( 2003, July-December). Uncovering the health challenges facing people with disabilities: The role of health insurance. Health Affairs, pp. 552-566.
13.
Hart Research Associates. (2001). Workers’ rights in America: What workers think about their jobs and employers. Washington, DC: AFL-CIO .
14.
Hart Research Associates. (2005). Labor Day 2005: The state of working America. Washington, DC: AFL-CIO.
15.
Helman, R., Greenwald, M., & Fronstin, P. ( 2004). Public attitudes on the U.S. health care system: Findings from the Health Confidence Survey (Issue Brief No. 275). Washington, DC: Employee Benefit Research Institute.
16.
Highlights from the 2003 Health Confidence Survey-Facts from EBRI. (2003 ). Washington, DC: Employee Benefit Research Institute.
17.
Hinkle, D., Wiersma, W., & Jurs, S. ( 1988). Applied statistics for the behavioral sciences (2nd ed.). Boston: Houghton Mifflin.
18.
Institute of Medicine. (2002). Care without coverage: Too little, too late. Washington, DC: National Academy Press.
19.
Institute of Medicine. (2003). Hidden costs, value lost: Uninsurance in America. Washington, DC: National Academy Press.
20.
Leatherman, S., & McCarthy, D. ( 2002). Quality of health care in the United States: A chartbook . New York: The Commonwealth Fund .
21.
Lustig, D., Strauser, D., & Donnell, C. ( 2003). Quality employment outcomes: Benefits for individuals with disabilities. Rehabilitation Counseling Bulletin, 47, 5-14.
22.
Merlis, M. ( 2002). Family out-of-pocket spending for health services: A continuing source of financial insecurity (Pub. No. 509). New York: The Commonwealth Fund.
23.
Merlis, M., Gould, D., & Mahato, B. ( 2006). Rising out-of-pocket spending for medical care: A growing strain on family budgets (Pub. No. 887). New York: The Commonwealth Fund.
24.
Muennig, P., Franks, P., & Gold, M. ( 2005). The cost effectiveness of health insurance. American Journal of Preventive Medicine, 28, 59-64.
25.
Neri, M., & Kroll, T. ( 2003). Understanding the consequences of access barriers to health care: Experiences of adults with disabilities. Disability and Rehabilitation, 25, 85-96.
26.
Pauly, M. ( 2005). Effects of insurance coverage on use of care and health outcomes for nonpoor young women. American Economic Review , 95, 219-223.
27.
Rehabilitation Services Administration, U.S. Department of Education. (1998). A longitudinal study of the vocational rehabilitation service program-Third interim report: Characteristics and outcomes of former VR consumers with an employment outcome (ED Contract No. HR92-022-001) . Washington, DC: Research Triangle Institute.
28.
Rehabilitation Services Administration, U.S. Department of Education. (2005). Percent mean hourly wage at closure- Competitive employment outcomes to state mean hourly wage. Retrieved January 4, 2008, from http://www.ed.gov/rschstat/eval/rehab/statistics.html
29.
Rosenthal, R., & Rosnow, R. ( 1991). Essentials of behavioral research: Methods and data analysis (2nd ed.). Boston: McGraw-Hill.
30.
Rosenthal, R., Rosnow, R., & Rubin, D. ( 2000). Contrasts and effect sizes in behavioral research: A correlational approach. Cambridge, UK: Cambridge University Press.
31.
Rumrill, P., & Roessler, R. ( 1999). New directions in vocational rehabilitation: A career development perspective on closure. Journal of Rehabilitation , 65(1), 26-30.
32.
Sampson, J., Reardon, R., Peterson, G., & Lenz, J. ( 2004). Career counseling and services: A cognitive information processing approach. Belmont, CA: Brooks/Cole .
33.
Schoen, C., Doty, M., Collins, S., & Holmgren, A. ( 2005). Insured but not protected: How many adults are underinsured? (Pub. No. 838). New York: The Commonwealth Fund.
34.
Secombe, K., Hartley, H., Newson, J., Hoffman, K., Marchand, G., Albo, C., et al. (2007). The aftermath of welfare reform: Health, health insurance, and access to care among families leaving TANF in Oregon. Journal of Family Issues, 28, 151-181.
35.
Shen, Y., & Long, S. ( 2006). What’s driving the downward trend in employer-sponsored health insurance? Health Services Research, 41, 2074-2096.
36.
Shoob, M. ( 2001, spring-summer). A reflection on the vocational rehabilitation program. American Rehabilitation, inside front cover.
37.
Sommers, A. ( 2006/2007). Access to health insurance, barriers to care, and use among adults with disabilities. Inquiry, 43, 393-405.
38.
Taylor, H., & Leitman, R. (Eds.). (2003). Fundamental health care values. Health Care News, 3(3), 1-5.
39.
The Commonwealth Fund 2006 Report. (2006). New York: The Commonwealth Fund.
40.
The many sources of stress and the hassles of daily life-Harris Poll #75. (2006). Rochester, NY: Harris Poll.
41.
U.S. Census Bureau. (2005). Poverty thresholds-2005. Retrieved January 4, 2008, from http://www.census.gov/hhes/www./poverty/threshld/thresh06.html
42.
U.S. Department of Labor. (2004). National Compensation Survey: Occupational wages in the United States, July 2003-Bulletin 2568. Retrieved January 7, 2009, from http://www.bls.gov/ncs/ocs/sp/ncbl0658.pdf
43.
U.S. Department of Labor. (2005a). National Compensation Survey: Employee benefits in private industry in the United States, March 2005-Bulletin 2589. Retrieved March 20, 2008, from http://www.bls.gov/ncs/ebs/home.htm
44.
U.S. Department of Labor. (2005b). National Compensation Survey: Employee benefits in private industry in the United States, March 2005-Summary. Retrieved March 20, 2008 , from http://www.bls.gov/ncs/ebs/home.htm
45.
West, M., Kregel, J., & Banks, P. ( 1990). Fringe benefits available to supported employment participants . Rehabilitation Counseling Bulletin, 34, 126-138.
