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April 2013 St@teside

New SHADAC Report on Employer-Sponsored Insurance Trends in States

The State Health Access Data Assistance Center (SHADAC) has released its updated “State Level Trends in Employer-Sponsored Health Insurance” report. Building on a report originally published in June 2011, this update provides further analysis of the employer-sponsored insurance (ESI) market both at the state and national levels.
The report found that ESI coverage levels for people under age 65 have continued to decline from 69.7 percent in 1999/2000 to 59.5 percent in 2010/2011. While the rate of public coverage increased over this period, it was not enough to offset the drop in ESI coverage, leading to an increase in the uninsurance rate from 14.7 percent to 17.8 percent. These declines in ESI coverage have disproportionately impacted low income populations, as those with household incomes below 200 percent of the Federal Poverty Guideline (FPG) experienced greater declines in ESI than those with household incomes at or above 400 percent FPG.
The SHADAC report further cites several trends in employer-related factors that are contributing to the decline of ESI. These factors include:
  1. Decrease in private sector employers offering coverage from 58.9 percent in 1999/2000 to 52.4 percent in 2010/2011;
  2. The percentage of workers who are employed at establishments offering ESI declined from 89.3 percent to 85.9 percent; and
  3. The take-up rate of ESI by employee eligible employees dropped from 81.8 percent in 1999/2000 to 76. 3 percent 2010/2011.
  4. Furthermore, the declining trend in ESI also was marked by an increase in the cost of health insurance premiums. The costs for both single and family coverage more than doubled from 1999/2000 to 2010/2011. This translated to an increase in employee contribution from 17.5 percent to 20.8 percent of the total premium for single coverage, and from 23.8 percent to 26.6 percent for family coverage.

At the state level, ESI rates fell in 47 states, with substantial variation in the magnitude of decline and the levels of ESI coverage. Michigan’s 15.2 percentage point decrease in ESI was the largest, while Nebraska had the smallest decline of 4.3 percentage points; only three states – Massachusetts, North Dakota, and Alaska – had stable rates of ESI coverage. New Mexico had the lowest percentage of ESI coverage at 48 percent, while New Hampshire had the highest at 73.8 percent.
The report and state factsheets can be viewed here. An interactive map can also be viewed at the Robert Wood Johnson Foundation’s website.