• Terceira Ann Berdahl and Asako S Moriya.
• Agency for Healthcare Research and Quality, 5600 Fishers Lane, Rockville, MD, 20852, USA. Terceira.berdahl@ahrq.hhs.gov.
• J Gen Intern Med. 2021 Jul 1; 36 (7): 1997-2003.

ObjectiveTo estimate insurance disparities across non-standard employment categories and to determine how coverage disparities shifted following health reform in 2014.MethodsWe analyzed nationally representative data on working-age adults from the Medical Expenditure Panel Survey (MEPS) (2010-2012 and 2015-2017, N=79,182) to estimate insurance rates across three groups of non-standard workers (full-time temporary workers, freelancers, and part-time workers) compared to standard workers.ResultsUninsurance decreased after health reform for all groups of non-standard workers, ranging from a 10.0- to 14.3-percentage point decline (p<0.001). Yet, uninsurance rates remained high for freelancers (30.8%), full-time temporary workers (25.1%), and part-time workers (17.9%) relative to standard workers (11.9%) in 2015-2017 (p<0.001). Residence in a Medicaid expansion state was associated with lower uninsurance rates for all categories of workers.ConclusionsWorkers in non-standard jobs continue to face challenges obtaining health insurance coverage. Our findings highlight the continued high risk of uninsurance for full-time temporary workers and freelancers.© 2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.

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