Long-Term Trends in Employer-Based Coverage

Employer-based health insurance is the most important source of health coverage for the nonelderly, covering about 58% of this population in 2017. The workplace has long been a significant source of coverage for those in working families, although its importance has been declining for a number of years, particularly among those in lower and moderate-income households.  This brief presents data from the National Health Interview Survey to examine trends in the share of nonelderly people who receive and are offered coverage through a job. A description of our methods is available below.

We find that the share of the nonelderly with employer-sponsored health insurance fell by almost 9 percentage points between 1999 and 2017, with larger percentage reductions generally occurring for income groups below 400% of poverty than above. Overall, if coverage rates had stayed at the 1999 level (67.3%), almost 24 million additional people would have been covered by employer-sponsored plans in 2017. Although the long-term trend shows a decline in the rate of employer-sponsored coverage, the share of people with job-based coverage did rise modestly between 2013 and 2017.

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