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The Fraying Link Between Work and Health Insurance

Trends in Employer-Sponsored Insurance for Employees, 2000-2007

Kaiser Family Foundation Report
November 2008
Peter J. Cunningham, Samantha Artiga, Karyn Schwartz

Most nonelderly Americans still obtain health insurance coverage through an employer. Nevertheless, the percentage of nonelderly people with employer-sponsored insurance (ESI) coverage has declined steadily since 2000. The decrease in ESI coverage during this decade represents a marked change from prior years. Between 1996 and 2000, ESI coverage increased because of strong economic growth, lower unemployment and a tight labor market that made employers reluctant to either drop coverage or substantially increase patient cost sharing, despite rapidly increasing premium costs.

However, ESI coverage began declining after 2000 as a result of an economic downturn between 2001 and 2004 that saw rising unemployment, declining family incomes and more workers moving into temporary work, part-time work and other employment situations where health benefits were not provided. ESI coverage continued to decline after 2003 despite improvements in the general economy and slower growth in health care costs. This study examines the factors driving the decrease in ESI since 2000.

This Kaiser Family Foundation study was conducted by HSC Senior Fellow Peter J. Cunningham, Ph.D., and KFF Senior Policy Analysts Samantha Artiga and Karyn Schwartz.

Free access to this article is available at the Kaiser Family Foundation Web site by clicking here.





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The Center for Studying Health System Change Ceased operation on Dec. 31, 2013.