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Employment-Based Health Benefits: Trends in Access and Coverage, 1997-2010

36 Pages Posted: 25 Apr 2012  

Paul Fronstin

Employee Benefit Research Institute (EBRI)

Date Written: April 1, 2012


Employment-based health benefits are the most common form of health insurance in the United States. The purpose of this paper is to examine the state of employment-based health benefits among workers with respect to offer rates, coverage rates, and take-up rates. It also examines how the state of employment-based health benefits has changed since the mid-1990s, reasons why workers do not have employment-based health benefits from their own employers, and how these reasons have changed since the 1990s. Both the offer rate (the percentage of workers offered a health benefit) and the coverage rate for employment-based health benefits declined between 1997 and 2010. Between 1997 and 2010, the percentage of workers offered health benefits from their employers decreased from 70.1 percent to 67.5 percent, and the percentage of workers covered by those plans decreased from 60.3 percent to 56.5 percent. The take-up rate (the percentage of workers taking coverage when offered by their employers) declined from 86 percent in 1997 to 83.6 percent in 2010. In 2010, 58.7 percent of nonelderly individuals were covered by employment-based health plans, with 68.6 percent of working adults covered, 35.3 percent of non-working adults covered, and 54.8 percent of children covered. The percentage of the population with employment-based health benefits has been declining, most recently due to the 2007-2009 recession. The percentage of individuals under age 65 with employment-based health benefits fell from 62.4 percent in 2008 to 58.7 percent in 2010, and the percentage of workers with coverage through their own employers fell from 54.2 percent in 2007 to 51.5 percent in 2010, its lowest level since 1994. In 2010, 46.7 percent of wage and salary workers ages 18-64 reported that they worked for employers that did not offer health benefits. Another 14.7 percent worked for employers that provided health benefits but were not eligible for those benefits. Among workers who were not eligible for their employers’ health plans, 38.7 percent were uninsured in 2010, and 41.1 percent had employment-based health benefits as dependents. Two-thirds of workers not eligible for their employers’ health plans reported that they worked part time in 2010, up from one-half in 1997. In 2010, one-quarter of workers reported that they were offered health benefits but they chose not to participate. Between 1997 and 2010, the percentage of workers who declined coverage because of cost increased from 23.2 percent to 29.1 percent. In 2010, two-thirds reported that they declined coverage because they had other coverage, down from 78.9 percent in 1997. The estimates presented in this paper can also serve as a baseline against which to measure the impact of the Patient Protection and Affordable Care Act of 2010 (PPACA) on employment-based health benefits in the future.

Keywords: Demographics, Employment-based benefits, Health care access, Health insurance coverage, Uninsured

JEL Classification: I1, J11, J3, J32

Suggested Citation

Fronstin, Paul, Employment-Based Health Benefits: Trends in Access and Coverage, 1997-2010 (April 1, 2012). EBRI Issue Brief, No. 370, April 2012. Available at SSRN:

Paul Fronstin (Contact Author)

Employee Benefit Research Institute (EBRI) ( email )

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