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Although job insecurity has received growing recognition in connection with the transformation of working life, little is known about how unionization affects its consequences. Data from Swedish health care employees indicate that job insecurity is related primarily to coping strategies in the exit and voice domains. Union members were less inclined to make use of the exit and voice options compared with their non-unionized co-workers, and more typically expressed loyalty to the organization. The collective support derived from union membership may make individual voice expressions less important, a finding that has to be replicated in countries with lower unionization rates.