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How Employers Support Lower-Waged Workers’ Access to Health Insurance Options

Health insurance makes up 8% of total employee compensation on average, and while most employees take up health insurance when it is offered, lower-wage workers are far less likely to be able to access coverage, according to a new Peterson-KFF Health System Tracker analysis of survey data and focus groups with more than 100 U.S. employers with over a quarter of a million employees.

What Are the Recent Trends in Employer-Based Health Coverage?

Policy Changes Bring Renewed Focus on High-Deductible Health Plans

Health Insurer Financial Performance in 2024

Examining Short-Term Limited-Duration Health Plans

Health Care Affordability

BTD Health Policy in 2026

Health Policy in 2026

President and CEO Dr. Drew Altman forecasts eight things to look for in health policy in 2026. “First and foremost,” he writes, “is the role health care affordability will play in the midterms.” And, he notes: “The average cost of a family policy for employers could approach $30,000 and cost sharing and deductibles will rise again after plateauing for several years.”

View all of Drew’s Beyond the Data Columns

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  • Premiums and Worker Contributions Among Workers Covered by Employer-Sponsored Coverage, 1999-2021

    Interactive

    This graphing tool allows users to explore trends in workplace-sponsored health insurance premiums and worker contributions over time for different categories of employers based on results from the annual Employer Health Benefits Survey. Breakouts are available by firm size, region and industry, as well as for firms with relatively few or many part-time workers, higher- or lower-wage workers, and older or younger workers.

  • No Surprises Act Implementation: What to Expect in 2022

    Issue Brief

    The “No Surprises Act,” which establishes new federal protections against most surprise out-of-network medical bills when a patient receives out-of-network services during an emergency visit or from a provider at an in-network hospital without advance notice, will take effect next month. A new KFF brief outlines what to expect in 2022.

  • Consumer Appeal Rights in Private Health Coverage

    Issue Brief

    The Affordable Care Act (ACA) gives consumers the right to appeal private health plan claims denials and other adverse decisions, including the incorrect application of cost sharing, although limits apply. This issue brief describes consumer access to appeals and limits on appeal rights that have been adopted through federal regulations.

  • Examining Prior Authorization in Health Insurance

    Policy Watch

    This post explains what's known about how insurers use prior authorization as a tool to control costs and encourage cost-effective care, the state and federal laws that govern it, and ongoing policy debates over efforts to impose standards to limit or regulate its use.

  • Women who Give Birth Incur Nearly $19,000 in Additional Health Costs, Including $2,854 More that They Pay Out of Pocket

    News Release

    The health care costs associated with pregnancy and childbirth average almost $19,000, including $2,854 paid out-of-pocket, a new KFF analysis of large employers’ insurance claims finds. Unlike other analyses that examine costs of specific pregnancy-related services, such as a vaginal or cesarean delivery, this new analysis compares three years of health care claims for reproductive-aged women who gave birth to claims for women who had not given birth. The analysis finds women who give birth…

  • Five Things to Know about the Renewal of Extra Affordable Care Act Subsidies in the Inflation Reduction Act

    Policy Watch

    As part of the Inflation Reduction Act, the Senate recently passed a three-year extension (through 2025) of enhanced subsidies for people buying their own health coverage on the Affordable Care Act Marketplaces. The enhanced subsidies increase the amount of financial help available to those already eligible and also newly expand subsidies to middle-income people, many of whom were previously priced out of coverage. Here’s what to know about the likely renewal of these subsidies:

  • Mental Health Parity at a Crossroads

    News Release

    With federal agencies preparing to update parity regulations and Congress considering reforms, our new report explains existing parity requirements, including who they apply to and how their enforced, and highlights key policy issues raised by regulators and advocates that could be addressed in the future. Those issues include: Simplifying parity standards to make it easier for apples-to-apples comparisons between behavior health and medical benefits needed to assess compliance. Taking a closer look at how insurers are…

  • Many Privately Insured People with Diabetes Could Save Money if Congress Caps Insulin Costs

    News Release

    Several legislative proposals in Congress propose a $35 per month cap on what people with health insurance would have to pay out of pocket for insulin, a life-saving hormone taken regularly by many people with diabetes to maintain their health. Such a cap could provide financial relief to at least 1 out of 5 insulin users with different types of private health insurance, a new KFF analysis of insurance claims data finds. In the large…

  • Marketplace Insurers Denied Nearly 1 in 5 In-Network Claims in 2020, though It’s Often Not Clear Why

    News Release

    Healthcare.gov marketplace insurers denied nearly one out of every five claims (18%) submitted for in-network services in 2020, though why the denial rates are so high and the ultimate consequences for consumers are difficult to access from the publicly available data, a new KFF analysis finds. The Affordable Care Act requires insurers to report data about claims denials and appeals to encourage transparency about how insurance coverage works for enrollees. The analysis examines data released…