Diminishing offer and coverage rates among private sector employees
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (Henry J. Kaiser Family Foundation)
- Author(s):
- Claxton, Gary, author Levitt, Larry, author Damico, Anthony, author
- Contributor(s):
- Henry J. Kaiser Family Foundation, issuing body.
- Publication:
- Menlo Park, CA : Henry J. Kaiser Family Foundation, September 2016
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Health Benefit Plans, Employee -- statistics & numerical data Insurance Coverage -- statistics & numerical data United States United States.
- Genre(s):
- Technical Report
- Abstract:
- The recent release of 2015 information from the Insurance Component of the Medical Expenditure Panel Survey (MEPS-IC) shows continuation of the fairly long-term decline in the share of private-sector workers in small firms that are offered coverage and that receive coverage at their job. This is part of a larger, long-term trend that shows a decline among all private-sector workers in the percentage who are covered by their own employer. While many of these workers are able to find coverage from other sources, such as coverage as a dependent through a spouse or through a public program, the decline is a concern because employer-based coverage is by far the largest source of coverage in the U.S., and its diminishing reliability puts more workers at risk of being left without a source of coverage. Workers who are not offered coverage at their job in general are more likely to be uninsured than workers who are. Among workers aged 18 to 64 at private industries, 28 percent of workers without an offer of employer sponsored insurance (ESI) were uninsured compared to only 4 percent of workers with an offer of ESI1. Workers without an offer of ESI are natural beneficiaries of the new coverage options under the Affordable Care Act (ACA), and we find that the rate of uninsurance fell after 2013 among workers in smaller establishments not offered coverage at their job. We use information from multiple years of the MEPS-IC to look at long-term trends in health insurance offer and enrollment rates in private sector establishments, broken out by size of firm. Although MEPS-IC surveys state and local government employers, we have limited this analysis to the private sector since a very large share of governments offer health benefits to their workers. It also is not possible to classify state and local government workers by "firm or establishment size" in the MEPS-IC with available public information. We also use the National Health Interview Survey (NHIS) to look at health insurance status over time. NHIS provides the most current coverage information and it permits us to differentiate workers based on whether or not they were offered coverage at their job. Beginning in 2001, NHIS contains information about the size of the establishment for workers (Generally, "establishment" refers to a business location, while "firm" refers to the whole enterprise and may include multiple locations. See Methods Box for difference between "firm" and "establishment"). Overall, we find from the MEPS-IC that the percentage of workers in private-sector businesses who work in firms that offer health benefits and who are eligible for those benefits ("Share Offered") has been falling for many years, as has the percentage of workers covered by health insurance in their own firm ("Share Covered"). These declines were particularly large for workers in firms with fewer than 50 employees. The NHIS shows that the uninsurance rate for workers in small establishments who are not offered health insurance at work has been consistent and high over many years, but fell when the new ACA coverage options were implemented in 2014. While an improvement in the insurance status for these workers, their rates of uninsurance remains considerably higher than those of workers in small establishments who are offered coverage at their job.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (7 pages, 1 unnumbered page))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101694289 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101694289