Provision of employer-sponsored health insurance in small businesses: Does rural location matter?

Because employer-sponsored programs are the predominate means by which most non-elderly Americans are covered by health insurance, there is interest in the extent to which observed spatial differences occur because of structural differences in rural and metro economies. We examine factors influencing the costs employers face in providing health insurance to their employees, and how these costs compare in importance to other firm-level and regional economic factors that may impact their decision to offer health insurance to their workers. Overall, we find that costs, rather than either firm-level characteristics or rurality per se, are the most important determinant.