Private Insurance

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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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  • 2025 Health Insurance Marketplace Calculator

    Feature

    The Health Insurance Marketplace Calculator, updated with 2025 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA).

  • 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.

  • Employer Responsibility Under the Affordable Care Act

    Other Post

    The Affordable Care Act does not require businesses to provide health benefits to their workers, but applicable large employers may face penalties if they don’t make affordable coverage available. The employer shared responsibility provision of the Affordable Care Act penalizes employers who either do not offer coverage or do not offer coverage that meets minimum value and affordability standards. These penalties apply to firms with 50 or more full-time equivalent employees. This flowchart illustrates how…

  • Medical Debt Among New Mothers

    Issue Brief

    This analysis examines the share of new mothers who have significant medical debt (in excess of $250), compared to other young women who did not recently give birth, using data from the Survey of Income and Program Participation (SIPP).

  • Another Year of Record ACA Marketplace Signups, Driven in Part by Medicaid Unwinding and Enhanced Subsidies

    Policy Watch

    Open enrollment for the Affordable Care Act (ACA) Marketplaces is about to wrap up with another record high number of people signing up for coverage. Factors that contribute to this increase include unwinding of the Medicaid continuous enrollment, increased subsidies from the American Rescue Plan and Inflation Reduction Act, and increased marketing, outreach, and enrollment assistance.

  • Analysis of 2016 Premium Changes and Insurer Participation in the Affordable Care Act’s Health Insurance Marketplaces

    Issue Brief

    This analysis provides an early look at premium changes for individuals in the health insurance marketplaces, created under the Affordable Care Act (ACA), in major cities in 10 states plus DC. Premium changes for the benchmark silver plans vary significantly across the sample cities. The benchmark rates will increase 4.4 percent on average in 2016 without accounting for tax credits, a relatively modest amount but greater than the average increase for 2015.

  • About 1 in 6 Emergency Visits and Hospital Stays Had At Least One Out-of-Network Charge in 2017

    News Release

    In roughly 1 of every 6 emergency room visits and inpatient hospital stays in 2017, patients came home with at least one out-of-network medical bill, a new KFF analysis finds. More specifically, 18 percent of all emergency visits and 16 percent of in-network hospital stays had at least one out-of-network charge, leaving patients at risk for surprise medical bills, according to the analysis of claims data from large employer plans. The analysis also finds the…