The Erosion of Employment-Based Insurance: More Working Families Left Uninsured

Abstract

The number of Americans without health insurance rose from 38.4 million in 2000 to 47.0 million in 2006, primarily due to the precipitous decline in employer-provided health coverage for workers and their families. Nearly 3.9 million fewer Americans under 65 had employer-provided coverage in 2006 than in 2000. The downward trend in the rate of employer-provided insurance continued for the sixth year in a row, falling from 68.3 to 62.9 percent. Individuals among the bottom 20 percent of household income were the least likely to have employer coverage. Jobholders experienced a significant decline in health insurance coverage, from 74.8 percent of workers in 2000 to 70.8 percent in 2006. No category of workers was insulated from loss of coverage. Children experienced declines in employer-provided health insurance coverage (through their parents) in each of the past five years, the rate falling from 65.9 percent of children in 2000 to 59.7 percent in 2006. Public health insurance (Medicaid and the State Children's Health Insurance Program) is no longer offsetting these losses. The decline in employer-provided coverage was felt throughout the country. Between the 2000–2001 and 2005–2006 periods, 38 states experienced significant losses in employment-based coverage for the under-65 population. No state experienced a significant increase in the coverage rate.