Employer-Sponsored Insurance Stable For Low-Income Workers In Medicaid Expansion States.

Area of Science:

• Health Services Research
• Health Economics
• Public Health Policy

Background:

• Employer-sponsored health insurance is a primary source of health coverage in the United States.
• Understanding trends in offer, take-up, and coverage is crucial for evaluating health policy impacts.
• The Patient Protection and Affordable Care Act (ACA) influenced employer and individual health insurance markets.

Purpose of the Study:

• To assess changes in employer health insurance offer, take-up, and coverage rates between 2013 and 2017.
• To examine these trends specifically among workers with family incomes at or below 138% of the federal poverty level in Medicaid expansion states.

Main Methods:

• Analysis of worker-level data from June 2013 and March 2017.
• Calculation of offer, take-up, and coverage rates for employer-sponsored health insurance.
• Stratification of analyses by income level and state Medicaid expansion status.

Main Results:

• Overall employer health insurance offer rates remained stable between 2013 and 2017.
• Take-up and coverage rates for employer-sponsored health insurance showed an increase during the study period.
• In Medicaid expansion states, employer-based coverage for low-income workers (≤138% federal poverty level) was stable, while uninsurance rates decreased.

Conclusions:

• Employer-sponsored health insurance markets demonstrated stability in offers but growth in utilization.
• Medicaid expansion appears to have contributed to reduced uninsurance among low-income workers without negatively impacting employer coverage stability.
• These findings highlight the complex interplay between public and private insurance mechanisms in the evolving healthcare landscape.