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Fewer Employers Offer Health Insurance , Fewer Employees Sign Up

February 22, 2017

The percentage of employers offering health insurance fell to 45.7 percent, driven largely by more small employers not offering health benefits. This is according to new data from the University of Minnesota.

Funded by the Robert Wood Johnson Foundation, researchers at the State Health Access Data Assistance Center (SHADAC) say larger employers increased their offers of insurance, but those gains were more than offset by small employers dropping insurance benefits. The researchers also found big differences between states in whether or not health insurance was offered by employers of different sizes.

Researchers say the findings may be partially explained by large employers adding coverage benefits to meet the rules of the Affordable Care Act, while small employers may have shed some employees or reduced hours to remain under the threshold where offering health insurance benefits is required.

Nationwide, 83.8 percent of workers were employed in jobs that were accompanied by offers of insurance, and 75 percent of workers who were eligible for the offered coverage chose to enroll—a relatively slight decline from previous levels. The data come from the Medical Expenditure Panel Survey-Insurance Component, produced by the Agency for Healthcare Research and Quality, and reflect changes from 2014 to 2015 figures, the most recent available.   

States experienced wide variation in both employer-offered insurance and employee acceptance of those offers. Hawaii had the largest proportion of workers in jobs with employer-sponsored coverage (97.7%) and the highest employee take-up rates (81.5%). Montana had the lowest proportion of workers in jobs with employer coverage (66.6%), while Colorado had the lowest employee take-up of such offers (67.9%).

“Even with overall coverage expansions under health reform, most people still get insurance through work,” said Lynn Blewett, director of SHADAC. “As more autonomy is given to states to design insurance markets of their own, it will be important to ensure a consistent level of benefits are offered nationwide, or the variation between states will increase.”

Nationwide, overall employer offers of health insurance fell by 1.8 percentage points, to 45.7 percent. Larger employers’ offers of insurance increased by 1.2 percentage points, to 96.0 percent, but were offset by offers from small employers, which decreased by 2.8 percentage points, to 29.4 percent.

“Employer-sponsored coverage is the main source of health care coverage for Americans,” said Kathy Hempstead, senior adviser at the Robert Wood Johnson Foundation. “Trends in this market segment continue to be stable overall, despite some decline in offer rates among smaller firms.”

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For a copy of the full report or to schedule an interview with an expert, please contact Will Walters at [email protected] or 202-868-4821.

ABOUT THE STATE HEALTH ACCESS DATA ASSISTANCE CENTER
The State Health Access Data Assistance Center (SHADAC) is a program of the Robert Wood Johnson Foundation and a part of the Health Policy and Management Division of the School of Public Health at the University of Minnesota.

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