Nonstandard Work
Fending for Themselves
Nonstandard Workers, Health Insurance Coverage and the Labor Market

CONTACT: Mike Owen (319) 338-0773, ipp(at)

Read full report 59-pg PDF (includes executive summary)
Executive summary or 2-pg PDF

IOWA CITY, Iowa (Oct. 5, 2011) — A changing labor market is diverting workers from jobs that offer insurance toward nonstandard work or arrangements that make finding affordable insurance difficult, a trend that contributes to job instability, according to a new report.

Nonstandard work — part-time, contract, on-call and temporary jobs — has become more prevalent since 2005, researchers found in a national survey conducted as part of the report released Wednesday by the nonpartisan Iowa Policy Project (IPP).

“Employer-provided health insurance has become more rare and more expensive, leaving the economically weakest workers to fend for themselves,” said Noga O’Connor, an IPP research associate and co-author of the report, which was funded by the U.S. Department of Labor.

“Plus, as we show, nonstandard workers are significantly less likely than standard workers to have health insurance at all. This has serious implications for policy makers as they consider implementation or changes in the health reform law.”

Besides the growth of nonstandard work and the lack of insurance access through that sort of employment, the research included a survey that found confusion among consumers about their own coverage, and raised new questions about the possible over-reporting of insurance coverage.

The report found:

• The nation has seen a “remarkable rise” in the rate of nonstandard workers, from 27 percent to 40 percent in only four years.
• Health insurance is related to job turnover, as workers without insurance are more likely than insured workers to lose or change jobs.
• Despite increased scrutiny, the discount medical plan industry has serious gaps in regulation and uniformity of benefits to consumers.

Researchers recommend more study of issues affecting the growing number of Americans in nonstandard work arrangements.

O’Connor and colleague Andrew Cannon said the report shows that the rapid increase in health costs is only one reason for the steady erosion of employer-sponsored insurance.

“A big reason also is simply that movement of people into jobs that are not likely to offer insurance,” Cannon said.

IPP reports in 2005 and 2006 showed workers in nonstandard jobs tend not to have job-based insurance or retirement plans. The latest report, “Fending for Themselves,” follows a December 2010 study that illustrated problems faced by consumers in the discount medical plan industry. Besides Cannon and O’Connor, IPP Research Director Peter Fisher and Senior Research Consultant Colin Gordon co-authored the report.

As in the 2005 report, IPP researchers found some people identify themselves as having insurance but do not — only possessing a discount card that is not insurance.

IPP found similar results again, as 9 percent in IPP’s survey identified themselves as having a discount medical plan, but almost half of those considered it to be insurance.

“Our survey found that while 82 percent of our employed respondents claimed to have some health insurance, some had only a medical discount plan, reducing the real coverage rate shown by our survey to 78 percent,” the researchers said in a summary.

“The distinction between real and perceived coverage is important because it indicates other measures including the (Census Bureau’s) Current Population Survey, may overstate the rate of insurance coverage, and this may affect policy choices. Unlike our study, CPS does not follow up to determine if some of the self-identified insured have only a discount card.”

Cannon said the report raises a question about the transition to the implementation of the health reform law in 2014, or the resolution of court challenges to it.

“What do workers do, what can they do, when their employer does not provide them with insurance? This used to be the foundation of the nation’s health insurance system, but clearly, it has eroded,” he said.

The study was one of two produced by IPP and fully funded by the U.S. Department of Labor under a $335,043 contract, secured by Senator Tom Harkin, with the Employment and Training Administration for research on employment and training costs of uninsurance and the impact on contingent workers. Both full reports are available on the IPP website at

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Note: Fending for Themselves: Nonstandard Workers, Health Insurance Coverage, and the Labor Market, is the second of two reports prepared by the Iowa Policy Project for the Employment and Training Administration of the U.S. Department of Labor, in fulfillment of Agreement #: EA-18258-09-60-A-19. Fending for Themselves and an earlier report, Not Your Father’s Health Insurance: Discount Medical Plans and the Health Care Crisis, both were produced by the Iowa Policy Project and funded fully from this $335,043 contract for research on employment and training costs of uninsurance and the impact on contingent workers. The conclusions and recommendations contained in this report do not necessarily reflect the views of the Department of Labor.