Employer-based health care doesn’t work for people with lower incomes

About 60 percent of people who are not over 65 have employer-sponsored health insurance, reports the Kaiser Family Foundation. But, a significant portion of people eligible for employer coverage, primarily people with incomes under 200 percent of the federal poverty level, do not take it because of the cost.

Nearly 165 million people or about half the US population has employer-based health insurance. More than four in five employers offer coverage. As health care costs continue to rise and insurers delay and deny care and narrow their health care provider networks, even with insurance it can be hard to get care.

The high cost of health insurance and the ability of employers to charge their workers for it mean that our health care system discriminates against people with lower incomes even when they are eligible for employer coverage. Not even one in four (23.9 percent) people with incomes under 200 percent of the federal poverty level, who are eligible for employer-sponsored health insurance, elect it. Six in ten eligible (59 percent) people with incomes between 200 and 400 percent of the federal poverty level elect it. But, more than eight in ten (84,2 percent) people with incomes above 400 percent of the federal poverty level elect it.

Similarly, people with incomes under 200 percent of the poverty level were far less likely to work at a job that offered employer-sponsored health insurance than people with incomes over 4oo percent of the poverty level, 60.6 percent versus 88.2 percent. Because employers do not have to offer health insurance to all their workers, people with lower incomes end up less likely to have a job that offers them health insurance. About half of workers (49.5 percent) with incomes under 200 percent of the poverty level were eligible for coverage as compared to 84.6% of workers with incomes above 400% of the federal poverty level.

Employer-based health insurance also leads to racial discrimination, benefiting White individuals far more than non-White people. Black people, Hispanic people and American Indians are significantly less likely to take advantage of employer-based coverage than White people. Not even four in ten American Indians (39.6 percent) get employer-based coverage for which they are eligible, as compared to 68.4 percent of White people. Forty-five percent of Hispanic people and 52.6 percent of Black people get employer-based coverage.

Disparities in access to health insurance also exist by profession. People working in different industries have significantly different access to employer-sponsored health insurance. People working in fishing, farming and forestry are least likely to be offered employer-sponsored health insurance. Only 41.4 percent of them had access to coverage. In stark contrast, more than 85 percent of people working as professionals or in finance, business and other management positions had access to employer-coverage.

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