The state of employer-sponsored health insurance: 7 things to know

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A hearing from the U.S. Senate Committee on Finance welcomed testimonies on the current state of insurance coverage in America, with representatives from the Commonwealth Fund providing insight on employer-provided coverage.

Here are seven takeaways from the testimony:

1. A quarter of adults in employer-sponsored plans are underinsured while 42 percent have individual coverage but are considered underinsured. Both numbers have risen since 2010. 

2. The introduction of the ACA had created little change in the number of adults under 65 years old who have coverage through their employers. The percentage of adults under the age of 65 with employer-sponsored coverage spanned between 57 and 62 percent since 2012. 

3. Since the enactment of the ACA, nearly all companies with over 200 employees offer health insurance. However, between 2011 and 2020, the percentage of companies with 10 to 49 employees that offered coverage decreased as much as 15 percent. 

4. While the pandemic especially disrupted food services and retail industries, the pandemic resulted in a comparatively limited number of Americans who lost insurance (6 percent). This is because industries hit the hardest by layoffs had some of the lowest employee coverage rates before the pandemic. 

5. However, ACA coverage expansions mitigated employer-sponsored coverage losses during the pandemic-era recession. Twenty percent of affected employees found coverage through the Consolidated Omnibus Budget Reconciliation Act, followed by 16 percent using Medicaid, and 9 percent using marketplace or individual coverage. 

6. For the 180 million people with employer-provided coverage, average spending per person grew 21.8 percent between 2015 and 2019, outpacing inflation, GDP growth and median income in many states. This was mostly fueled by rising healthcare services and prescription drug prices, leading to higher premiums. 

7. The amount that workers pay for employer-funded insurance rose from 9.1 percent of median household income in 2010 to 11.6 percent in 2020.

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