EBRI Issue Brief
After Years of Erosion, More Employers are Offering Health Coverage; Worker Eligibility Higher
This paper examines the percentage of employers offering health insurance from 2008–2017 to better understand how health insurance offer rates may have been affected by the Patient Protection and Affordable Care Act of 2010 (ACA), the Great Recession of 2007–2009, and the subsequent economic recovery. The data come from the Medical Expenditure Panel Survey–Insurance Component (MEPS-IC).
Many employers were expected to drop workplace health insurance with the introduction of the ACA, and some have done so. Since 2008, the percentage of employers with 1,000 or more employees offering health benefits to workers has been consistently near or above 99 percent—it reached 99.8 percent in 2016—but smaller establishments have shown a steady, though not precipitous, decline in offer rates. For the smallest employers studied, those with fewer than 10 employees, the offer rate declined from 22.7 percent in 2015 to 21.7 percent in 2016.
However, in 2017, the overall percentage of private-sector employers offering health benefits increased for the first time since 2008. In 2008, 56.4 percent of private-sector employers offered health benefits. By 2016, it was down to 45.3 percent. It then increased to 46.9 percent in 2017. There have been years before 2017 when offer rates increased in various specific establishment size segments, perhaps due to the strengthening economy and lower unemployment rates.
- For employers with less than 10 employees, those offering health benefits increased from 21.7 percent to 23.5 percent between 2016 and 2017.
- For employers with 10–24 employees, those offering health benefits increased from 48.9 percent to 49.4 percent between 2015 and 2016.
- For employers with 25–99 employees, those offering health benefits increased from 73.5 percent to 74.6 percent between 2015 and 2016.
- For employers with 100‒999 employees, those offering health benefits increased from 92.5 percent to 96.3 percent between 2014 and 2016.
This paper discusses the context for the recent rebound and suggests factors that may influence future trends.