This Issue Brief provides
data on employment-based health insurance, with a discussion of
recent trends and how sponsorship rates, offer rates, coverage
rates, and take-up rates vary for different workers. Other
sections examine reasons why workers do not participate in
employment-based health plans, alternative sources of health
insurance, and uninsured workers.
In 1997, 83 percent of the 108.1
million wage and salary workers in the United States were
employed by a firm that sponsored a health plan. Of those
workers, 75 percent were offered coverage, and 62 percent (or
67.5 million workers) were covered by that plan. Of those workers
who worked for an employer that offered them a health plan, 83
percent participated in the plan.
Sponsorship rates have barely
changed in the last 11 years. In 1988, 83 percent of wage and
salary workers reported that their employer sponsored a health
plan. This declined slightly to 82 percent in 1993 but had
increased to 83 percent by 1997.
Offer rates significantly changed
between 1988 and 1997. In 1988, 82 percent of workers reported
that they were eligible for health insurance through their
employer. By 1993, the percentage of eligible workers declined to
74 percent, and it has only slightly increased since then to 75
percent in 1997.
In 1997, 40.6 million American
workers did not have health insurance through their own job.
Forty-five percent of the workers without coverage were employed
at a firm where the employer did not provide health insurance to
any workers. Thirty-three percent of the workers without coverage
were offered coverage but declined it. Twenty-two percent of the
workers without coverage were employed in a firm that offered
health insurance to some of its workers, but certain workers were
not eligible for the health plan.
The 13.7 million workers who were
offered coverage but declined it gave a number of reasons for
doing so. In the majority of cases (61 percent), the worker was
covered by another health plan. Of the remainder, 20 percent
reported that health insurance was just too costly.
Overall, 41 percent of the 40.6
million workers who were not participating in an employment-based
health plan through their own employer had coverage through a
spouse. However, 42 percent of the 40.6 million workers who
declined their employers' health plan or who were not offered
health insurance from their employer were uninsured.
