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Employment-based Health Coverage Still Dominates, But Slow Decline Continues
added: 2010-09-23

The ranks of Americans with employment-based health insurance declined by more than 2 percentage points last year, according to a new analysis by the nonpartisan Employee Benefit Research Institute (EBRI).

EBRI's calculations from recently released data from the U.S. Census Bureau show that employment-based coverage remains the dominant source of health insurance, but continues to erode. Overall, the percentage of individuals under age 65 with employment-based coverage declined from 61.1 percent in 2008 to 59 percent in 2009 - its lowest level in the 15-year period between 1994 and 2009.

The decline between 2008 and 2009 accelerated a long-term trend that has occurred during most years since 2000. Conversely, those in this group who did not have health insurance increased to 18.9 percent in 2009, up from 17.4 percent in 2008.

"These trends are due to job losses resulting from the recent recession and the slow economic recovery, fewer workers being eligible for health insurance coverage, and more workers with coverage choosing to drop it," said Paul Fronstin, author of the EBRI report. "With unemployment remaining high, these trends are almost certain to continue when the data are released for 2010."

Fronstin noted that fewer individuals are likely to be working this year (which means fewer with access to health benefits in the work place), and that federal COBRA subsidies that were meant to stem the erosion in employment-based coverage expired during the summer of 2010. "Coupled with uncertainty about the economy, the future of job security, and prospects for health reform, an increasing number of workers are likely to forego health coverage when it is available," Fronstin said.

EBRI's estimates of the uninsured are slightly higher than those published by Census Bureau because EBRI (unlike Census) counts only individuals under age 65. Medicare, the federal health care insurance program for the elderly and disabled, automatically covers those age 65 or over, so a more accurate measure of the uninsured excludes those with Medicare coverage.

Other key points of the EBRI report:

- Employment-Based Coverage Remains Dominant Source of Health Coverage, but Continues to Erode: Employment-based health benefits remain the most common form of health coverage in the United States. In 2009, 59 percent of the nonelderly population had employment-based health benefits, down from 68.4 percent in 2000 and 61.1 percent in 2008.

- Public Program Coverage Is Growing: Public program health coverage expanded as a percentage of the population in 2009, accounting for 21.1 percent of the nonelderly. Enrollment in Medicaid and the State Children's Health Insurance Program increased, reaching a combined 44.1 million in 2009, and covering 16.7 percent of the nonelderly population, significantly above the 10.5 percent level of 1999.

- Individual Coverage Stable: Individually purchased health coverage was unchanged in 2009 and has basically hovered in the 6-7 percent range since 1994.

Source: PR Newswire

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