NIHCR Research Brief No. 8
March 2012
Chapin White, James D. Reschovsky
Between 2007 and 2010, the share of children and working-age adults in the United States with employer-sponsored health insurance dropped 10 percentage points from 63.6 percent to 53.5 percent, according to a new national study by the Center for Studying Health System Change (HSC). The key factor driving the sharp decline was the enormous loss of employment during the Great Recession, which officially started in December 2007 and ended in June 2009. The proportion of the population younger than 65 with no workers in the family spiked 10 percentage points between 2007 and 2010, from 21.6 percent to 31.6 percent. The decline in employer coverage disproportionately affected young adults, people with a high school education or less, and people employed in small firms.
Even when employment rebounds to pre-recession levels, a return to previous levels of employer-sponsored health insurance is unlikely. Well before the start of the recession, a steady decline of employer health coverage was underway with fewer firms offering coverage and fewer workers taking up coverage—likely because of rising health care costs. Both of these trends continued during the recession and contributed to the decline in employer coverage between 2007 and 2010. The core threat to employer health coverage is health care costs increasing faster than wages, which makes employer coverage unaffordable for a larger share of the workforce, particularly low-wage workers. For example, among children and working-age adults with incomes below 200 percent of poverty—$44,100 for a family of four in 2010—the proportion with employer coverage dropped from 42 percent in 2001 to 24 percent in 2010.
Many people who lost employer coverage during 2007-2010 obtained public health coverage. National health reform, with its major expansion of Medicaid and new subsidies to purchase nongroup insurance, will further extend coverage to the growing ranks of Americans without employer health coverage.
This article can be accessed at the National Institute for Health Care Reform Web site.