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Having a job usually means having health insurance, but that’s not the case for nearly one in five working adults in the United States. The most recent census data, reports that 60 percent of uninsured adults in the United States are employed—that’s 23 million of the 38 million adults who were uninsured in 2008.
In Vermont—the state with the highest proportion of working uninsured—73 percent of uninsured adults are employed. Other states with notable proportions of working uninsured residents include North Dakota (71 percent), Kansas (68 percent), Maine (67 percent), Nebraska (66 percent), and Arkansas (64 percent).
The majority of Americans continue to receive health insurance through an employer, but the proportion of Americans with employer-sponsored insurance has declined over the past eight years. The percentage of nonelderly Americans with employer-sponsored insurance fell from 68 percent in 2000 to 62 percent in 2008. This is due in part to rising health care costs, which have increased the financial burden of coverage for businesses. Many businesses that offer health insurance to their employees are at pains to maintain that coverage. In fact, a recent survey shows that 43 percent of large firms feel pressured to increase employees’ premium costs.
With an absent health reform, American workers will continue to see their coverage erode through reduced benefits and increased cost sharing. In some instances, employers will stop offering health benefits altogether. Employer-sponsored coverage was once a stable source of coverage, but it no longer appears reliable.
Who is losing coverage?
The proportion of moderate-income workers—those with household incomes of approximately $40,000 per year—who have employer-based coverage fell by nearly 9 percent between 2007 and 2008. This group has experienced a sharper decline in employer-sponsored insurance than other income groups. These families—whose budgets are already stretched thin—find themselves in an even more precarious situation due to the particular vulnerability of their employer-provided health insurance coverage.
Many lower-income workers are also more vulnerable because of where they work. Only 53 percent of retail firms offer health benefits, for example, while 80 percent of firms in the manufacturing sector do. And retail employees that do receive coverage pay roughly 36 percent of family policy premiums, which is higher than employees at manufacturing firms, who pay 25 percent of premiums.
Workers need health care reform
Health insurance premiums that are rising three times faster than wages make employer-sponsored insurance a shaky source of coverage for families and an unsustainable expenditure for employers. Low- to middle-income working families who are not offered coverage often make too much to qualify for safety net programs. Health reform will help working families that are not offered coverage through their employer by expanding public programs and providing subsidies to help moderate-income families purchase coverage.
Reform will also help working families who currently have employer coverage and businesses that offer it by implementing measures that will rein in the rising costs of health care. Pending reform proposals will also provide small businesses with tax credits that would enable them to provide coverage to their employees.
Without comprehensive health reform that addresses all of these issues, American families and businesses will continue to bear the brunt of rising costs in a broken, highly inefficient system.
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