Listening to Workers: Challenges for Employer-Sponsored Coverage in the 21st Century

• Published in: Policy File 2000
• Main Authors: Duchon, Lisa, Schoen, Cathy, Simantov, Elisabeth, Davis, Karen, An, Christina
• Format: Report
• Language: English
• Subjects: Health care policy; Labor force/Employment; The Commonwealth Fund

More than 150 million Americans, or two of three individuals under age 65, receive health insurance through employers, making such coverage key to entrance into the U.S. health care system. Based on findings from The Commonwealth Fund 1999 National Survey of Workers' Health Insurance, most adults with employer-sponsored coverage think their employers do a good job of selecting quality plans and would like to see employers continue as a source of coverage in the future. Yet despite tight labor markets, this foundation fails to cover a sizable portion of the workforce: 44 million Americans were uninsured in 1998, the vast majority of whom work or are dependents of workers. The survey finds that sharp disparities in the availability of job-based coverage leave one-third of middle- and low-income workers uninsured, even when they work full time. The current system is clearly not working well for all American workers and their families. In addition to inequities in access to insurance, men and women's stories reveal uneven quality of care and widespread difficulties in getting and paying for needed health care. Beyond those currently uninsured, millions more may be at risk for losing their coverage because of difficulties paying their share of premiums -- especially if premiums rise markedly. Moreover, as frequent changes in plans become the norm rather than the exception, insurance coverage is increasingly insecure and unstable.