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

Employer-sponsored health insurance is the largest source of health coverage for people under 65. This analysis examines who among people under 65 have employer coverage and which workers are offered and eligible for coverage at their jobs, using the Annual Economic and Social (March) Supplements of the Current Population Survey.

Employer sponsored health insurance

Promotional image for KFF video The True Cost of Employer-Sponsored Health Insurance

Video: What Your Employer-Based Health Coverage Really Costs

More people get health coverage through their job than from any other source. The deduction workers see in each paycheck for their share of the premium is only a fraction of the total cost. In this video, KFF’s Matt Rae unpacks the full cost of employer-sponsored insurance and why it may be the biggest health care affordability story hiding in plain sight.

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  • Coverage of Sexual and Reproductive Health Services in Medicare

    Issue Brief

    This brief describes Medicare coverage of sexual and reproductive health services, including contraception, and compares that coverage with private insurance plans and Medicaid. These benefits are particularly relevant to nearly 1 million women of reproductive age (20-49) who are eligible for Medicare due to having a long-term disability.

  • Online Tools for Consumer-Directed Health Plans

    Event Date:
    Event

    On Jan. 25, 2005, Kaiser Family Foundation hosted a demonstration of the online tools made available to enrollees in consumer-directed health plans. Executives from Humana and Lumenos -- two major firms in the consumer-directed care market -- conducted real-time demonstrations of their consumer web tools to show how enrollees might manage the costs and quality of their care. Consumer-directed, or consumer-driven, health plans are intended to give enrollees a financial stake in their health care…

  • How Many of the Uninsured Can Purchase a Marketplace Plan for Free?

    Issue Brief

    This analysis looks at how many of the remaining uninsured are eligible for premium subsidies that are large enough to cover the entire cost of a bronze plan, which is the minimum level of coverage available on the Marketplaces. It estimates 27% of uninsured individuals who could shop on the ACA Marketplace, or 4.2 million people nationwide, are eligible to purchase a bronze plan with $0 premiums after subsidies in 2019.

  • Analysis: ‘Cadillac Tax’ on High-Cost Health Plans Could Affect 1 in 5 Employers in 2022

    News Release

    A new KFF analysis estimates that the Affordable Care Act’s tax on high-cost health plans would affect one in five (21%) employers offering health benefits when it takes effect in 2022 unless employers change their health plans. An even larger share (31%) could be affected when workers’ voluntary contributions to Flexible Spending Accounts are taken into account. The analysis comes as some in Congress are proposing to repeal the ACA’s tax on high-cost health plans,…

  • A Look at People Who Have Persistently High Spending on Health Care

    Issue Brief

    This analysis looks at the amounts and types of health spending for people with employer-based health insurance who have continuing high health care spending. It finds that, among people with three consecutive years of coverage from a large employer, just 1.3 percent of enrollees accounted for almost 20 percent of overall spending in 2017. This group – people in the top five percent of spending in each of the three years from 2015 to 2017…

  • A Small Group of Patients Account for a Whole Lot of Spending

    From Drew Altman

    You have heard about the 5% of the population responsible for 50% of spending. Meet the 1.3%--persistent high spenders with very complex medical needs responsible for 20%. Drew Altman discusses this and possible ways to help them, read the Axios column.

  • Individual Market Insurers Are Expecting to Pay a Record $800 Million in Rebates to Consumers for Excessive Premiums in 2018

    News Release

    Individual market insurers are expecting to return to consumers a record total of about $800 million in excess premiums for 2018, a year in which the insurance companies posted their best annual financial performance under the Affordable Care Act to date, finds a new KFF analysis. The rebates to more than 3 million eligible individual market consumers, based on preliminary estimates by insurers, must be issued by September 30. They are the result of the…

  • Analysis: Marketplace Plans Denied an Average of Nearly One in Five Claims in 2017 with Wide Variations across Insurers

    News Release

    Healthcare.gov marketplace insurers denied nearly one out of every five claims (19%) submitted for in-network services in 2017, and enrollees only appeal a tiny share (0.5%) of those denied claims, a KFF analysis of recently released claims data finds. The analysis finds a huge variation across insurers, with average denial rates as low as 1 percent and as high as 45 percent. Denial rates also vary across states, though individual insurers in the same state…

  • Analysis: Workers Increasingly Have Access to Same-Sex Spousal Benefits 

    News Release

    While workplace health benefits for married same-sex spouses are becoming more common, new data from KFF’s 2018 Employer Health Benefits Survey shows they still lag behind benefits available to opposite sex-spouses. In 2018, nearly two-thirds (63%) of employers offering health insurance coverage to opposite-sex spouses also provided coverage to same-sex spouses – up significantly from 2016, when fewer than half (43%) did. Few (6%) say they do not offer same-sex spousal benefits, while others, mostly…