Full-Time Employment Not Always a Ticket to Health Insurance

In this brief, author Jessica Carson examines differences in health insurance coverage by workers’ income, and explores who is eligible for an employer-based plan, who enrolls in those plans, and the reasons why workers choose not to enroll. She reports that, in 2016, only 33 percent of low-income workers (those below 200 percent of the official poverty threshold) employed full time, year round reported having employer-based health insurance, compared to 57 percent of higher-income workers. Low-income workers are less often offered insurance: 40 percent of low-income workers work for employers who do not offer insurance to any employee, compared to 18 percent of higher-income workers. For those whose employers offer plans, low-income workers are less likely to enroll, citing ineligibility and cost as barriers. When higher-income workers don’t enroll, it is most often because they do not need the plan. More than 25 percent of low-income workers employed full time, year round reported having no health insurance of any kind at any time in the previous year, compared with just 8 percent of higher-income workers. She concludes that as changes to health insurance policy continue to evolve, it is critical to keep in mind that full-time employment isn’t necessarily a ticket to health insurance, and that access to employer-based health insurance is stratified by income and industry