The Erosion of Employer-Sponsored Health Insurance: Declines Continue for the Seventh Year Running

Abstract

Employer-sponsored health insurance (ESI) remains the most prominent form of health coverage in the United States, at 62.9 percent of the under-65 population; however, the rate of this coverage has fallen every year since 2000, when 68.3 percent had ESI. By 2007, this rate had fallen 5.4 percentage points, and 3 million fewer people under the age of 65 had ESI in 2007 than in 2000. Because of these large declines in ESI, workers and their families have become uninsured at alarming rates. Despite a small gain in overall coverage for workers from 2006 to 2007, there were over 4 million more uninsured workers in 2007 than in 2000. Uninsured workers are disproportionately young, nonwhite, less educated, and low wage; however, workers across the socioeconomic spectrum experienced losses in coverage over the 2000-2007 period. Even the most highly educated and highest-wage workers had lower rates of insurance coverage in 2007 than in 2000. As with workers, the downward trend in ESI coverage for children (through their parents' employers) continued into 2007: 3.4 million fewer children had ESI in 2007 than in 2000, cutting across all race and income groups. Even as employment-based coverage has declined, the share of Americans who receive coverage through private purchase (non-group market) has also declined. The safety net programs--Medicaid and the State Children's Health Insurance Program--have kept millions of families insured as employment-based coverage fell.