Trends and Indicators in the Changing Health Care Marketplace Section 2: Trends in Health Insurance Enrollment
Printable Page Set
Trends and Indicators in the Changing Health Care Marketplace
Exhibit 2.1: Trends in Health Coverage for the Nonelderly Population, 2002 and 2003
The percent of the nonelderly population without insurance rose from 17.3% in 2002 to 17.7% in 2003 (or 44.7 million uninsured), an increase of 1.4 million over 2002. The proportion of Americans with employer-based insurance declined from 63.3% in 2002 to 61.9% in 2003.
Notes: Medicaid/Other Public includes the State Children’s Health Insurance Program, other state programs, Medicare, and military-related coverage. Medicare and military coverage represent 2% of health coverage among the nonelderly.
Source: Kaiser Family Foundation, Health Insurance Coverage in America, 2003 Data Update, November 2004, Table 1, p.28, at http://www.kff.org/uninsured/7153.cfm, prepared by the Kaiser Commission on Medicaid and the Uninsured, and the Urban Institute using data from the Census Bureau’s March Supplements to the Current Population Survey.
Trends and Indicators in the Changing Health Care Marketplace Information provided by the Health Care Marketplace Project. Publication Number:7031 Information Updated: 02/02/05
Trends and Indicators in the Changing Health Care Marketplace
Exhibit 2.2: Eligibility, Take-Up Rates, and Coverage in Firms Offering Health Benefits, 2005
Most Americans with health insurance have coverage through employer-sponsored health plans. In firms that offer coverage, 80% of workers were eligible for health benefits offered by their employer in 2005, and 83% of these workers participated in their employers’ plans, with the result that 66% of workers in firms that offer health benefits were covered by their employers’ health benefits plan in 2005.
Notes: Take-up rate is the percentage of eligible workers who choose to participate in health benefits offered by their employer.
Trends and Indicators in the Changing Health Care Marketplace Information provided by the Health Care Marketplace Project. Publication Number:7031 Information Updated: 04/27/06
Trends and Indicators in the Changing Health Care Marketplace
Exhibit 2.3: Health Plan Enrollment for Covered Workers, by Plan Type, 1988-2005
The increase in enrollment in managed care plans (including HMOs, PPOs, and POS plans) has been dramatic, rising from 27% of workers covered by employer plans in 1988 to 97% in 2005. PPO enrollment increased from 11% to 61% of covered workers from 1988 to 2005; HMO enrollment increased from 16% in 1988 to 31% in 1996, but has since declined to 21% in 2005. Conventional Fee-For-Service enrollment has declined from 73% of total enrollment in 1988 to 3% in 2005.
*Distribution is statistically different from the previous year shown at p<.05. No statistical tests were conducted for years prior to 1999. ^Information was not obtained for POS plans in 1988.
Note: A portion of the change in enrollment for 2005 is likely attributable to incorporating more recent Census Bureau estimates of the number of state and local government workers and removing federal workers from the weights.
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2005; KPMG Survey of Employer-Sponsored Health Benefits, 1993, 1996, 1998; The Health Insurance Association of America (HIAA), 1988. From Exhibit 5.1, at http://www.kff.org/insurance/7315/sections/ehbs05-5-1.cfm.
Trends and Indicators in the Changing Health Care Marketplace Information provided by the Health Care Marketplace Project. Publication Number:7031 Information Updated: 04/27/06
Trends and Indicators in the Changing Health Care Marketplace
Exhibit 2.4: Percentage of Firms Offering Health Benefits, by Firm Size, 1996-2005
Although nearly all large firms (200 or more workers) offer health benefits (98%), firms with fewer than 200 workers are significantly less likely to do so (59%). Since 2000, the percentage of small firms (3-199 workers) offering health benefits has dropped by 9 percentage points. While the year-to-year changes have been relatively small and not statistically significant, the cumulative effect has been a large and statistically significant change over this five-year period. This change is driven largely by a decrease in the percentage of small firms offering coverage, and may reflect several years of high premium growth combined with a sluggish job market.
*Estimate is statistically different from the previous year shown at p<.05. †Estimate is statistically different from the previous year shown at p<.10.
Note: The percentage of all large firms (200 or more workers) offering health benefits in 1999 was 99%, not 100% as reported last year. Data prior to 1999 do not reflect several methodological changes that were made to the survey, including standardizing survey weights to U.S. Census data.
Trends and Indicators in the Changing Health Care Marketplace Information provided by the Health Care Marketplace Project. Publication Number:7031 Information Updated: 04/26/06
Trends and Indicators in the Changing Health Care Marketplace
Exhibit 2.5: Percentage of Firms Offering Health Benefits to Part-Time and Temporary Workers, by Firm Size, 1999-2005
There has been little change in the percentage of firms offering health benefits to part-time workers and temporary workers since 1999. More than one quarter (28%) of all firms offered part-time workers health coverage and nearly one in twenty (3%) offered health benefits to temporary workers in 2005.
Notes: Tests found no statistically different estimates from the previous year shown at p<.05.
Trends and Indicators in the Changing Health Care Marketplace Information provided by the Health Care Marketplace Project. Publication Number:7031 Information Updated: 04/26/06
Trends and Indicators in the Changing Health Care Marketplace
Exhibit 2.6: Percentage of Employers Providing a Choice of Health Plans, by Firm Size, 2005
Larger firms (200 or more workers) are much more likely to offer employees a choice of health plans than are smaller firms. Only 19% of all small employers offered a choice of plans in 2005, compared to 73% of large employers and 83% of jumbo firms. However, larger companies employed a larger share of workers than did smaller firms. Thus, while only 20% of all firms offered a choice of plans in 2005, 63% of covered workers could select among multiple plans.
*Distribution is statistically different from All Firms at p<.05.
Trends and Indicators in the Changing Health Care Marketplace Information provided by the Health Care Marketplace Project. Publication Number:7031 Information Updated: 04/26/06
Trends and Indicators in the Changing Health Care Marketplace
Exhibit 2.7: Percentage of All Large Firms (200 or More Workers) Offering Retiree Health Benefits‡, 1988-2005
The percentage of firms offering retiree coverage has declined significantly over time, although there has been no significant change since 1993. Sixty-six percent of all large firms (with 200 or more workers) offered retiree coverage in 1988, compared with 33% in 2005.
‡Among firms that offer health benefits to active workers.
Note: Tests found no statistically different estimates from the previous year shown at p<.05. No statistical tests were conducted for years prior to 1999.
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2005; KPMG Survey of Employer-Sponsored Health Benefits, 1991, 1993, 1995, 1998; The Health Insurance Association of America (HIAA), 1988. From Exhibit 11.1, at http://www.kff.org/insurance/7315/sections/ehbs05-11-1.cfm.
Trends and Indicators in the Changing Health Care Marketplace Information provided by the Health Care Marketplace Project. Publication Number:7031 Information Updated: 04/26/06
Trends and Indicators in the Changing Health Care Marketplace
