A new report says employer-sponsored insurance has declined every year since 2000, currently leaving 45.7 million people under 65 without coverage – and another 10 million people will lose their coverage within the year unless the economy improves or health reform is passed.
“The current recession, rising unemployment and rising healthcare costs make health reform all the more important for American families now and in the future,” said Elise Gould, director of health policy research for the Economic Policy Institute, who authored the report.
According to the most recent data, compiled in 2008, about 1.8 million fewer people (under 65) were covered by health insurance through the workplace, while the rolls of public insurance – like Medicaid and the State Children’s Health Insurance Program (SCHIP) – expanded to include 3.4 million more people during the same period.
The largest declines in employer-sponsored insurance coverage for those under 65 occurred in Michigan, Tennessee, Missouri, South Carolina and North Carolina, with losses of at least 8 percent over the last decade.
Massachusetts and Hawaii rank among the highest in ESI coverage rates (Massachusetts at 72.5 percent, Hawaii at 71.5 percent) because both states have mandates requiring employers to offer basic insurance coverage to their workers.
However, another study, by the disability services advocacy organization PHI, revealed that even Massachusetts is plagued by ESI declines, especially in the home healthcare sector.
The study discovered that less than one-fifth of Massachusetts’ direct-care workers – nursing home assistants, home health aides and personal care attendants – are enrolled in employer-sponsored health insurance plans, primarily because they are too costly.
Researchers found that if workers are offered employer-sponsored health coverage, direct-care workers can’t access Massachusetts’ less-expensive subsidized health insurance programs. As a result, many choose to work part-time and enroll in either MassHealth or Commonwealth Care.
“This disincentive to work undermines state efforts to build a quality, stable, direct-care workforce,” said Amy Robbins, PHI’s Massachusetts policy director. “Direct-care work is among the fastest-growing job sectors, yet full-time workers really can’t afford employer-based insurance.”
There are 3 million direct-care workers nationally, and the number is projected to grow to 4 million by 2016, becoming the single largest occupational group in the United States. Direct-care workers lack health coverage at twice the rate of the nation’s general population.
“While considering proposals to expand access to healthcare coverage, Congress must heed what we learned from the Massachusetts model: It has done nothing to lower the cost of employer-sponsored health coverage, making it prohibitive for low-wage workers and their employers,” said Carol Regan, author of the report and PHI’s government affairs director.