The percentage of employers offering health insurance has fallen to 45.7 percent, driven largely by more small employers not offering health benefits, according to new data from the University of Minnesota.
Funded by the Robert Wood Johnson Foundation, researchers at the State Health Access Data Assistance Center say larger employers increased their offers of insurance, but those gains were more than offset by small employers dropping insurance benefits. The researchers also found big differences between states in whether or not health insurance was offered by employers of different sizes.
Researchers say the findings may be partially explained by large employers adding coverage benefits to meet the rules of the Affordable Care Act, while small employers may have shed some employees or reduced hours to remain under the threshold where offering health insurance benefits is required.
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Nationwide, 83.8 percent of workers were employed in jobs that offered insurance, and 75 percent of workers who were eligible for that coverage chose to enroll -- a relatively slight decline from previous levels. The data come from the Medical Expenditure Panel Survey-Insurance Component, produced by the Agency for Healthcare Research and Quality, and reflect changes from 2014 to 2015 figures, the most recent available.
States experienced wide variation in both employer-offered insurance and employee acceptance of those offers. Hawaii had the largest proportion of workers in jobs with employer-sponsored coverage, at 97.7 percent, and the highest employee take-up rates, at 81.5 percent. Montana had the lowest proportion of workers in jobs with employer coverage, at 66.6 percent, while Colorado had the lowest employee take-up of such offers: 67.9 percent.
"Even with overall coverage expansions under health reform, most people still get insurance through work," said Lynn Blewett, director of SHADAC, in a statement. "As more autonomy is given to states to design insurance markets of their own, it will be important to ensure a consistent level of benefits are offered nationwide, or the variation between states will increase."
Across the country, overall employer offers of health insurance fell by 1.8 percentage points, to 45.7 percent. Larger employers' offers of insurance increased by 1.2 percentage points, to 96 percent, but were offset by offers from small employers, which decreased by 2.8 percentage points, to 29.4 percent.