ABSTRACT
The decline of employment-based insurance during the past two decades has had a dramatic effect on insurance coverage in the U.S. The primary cause of the decline was the increased cost of private insurance, which triggered reductions in employment-based coverage. Between 1987 and 1995, the segment of the nonelderly population insured by employers fell from 69.2 to 63.8 percent (Employee Benefit Research Institute, 1997). With rising costs, many employers seemed to feel that “their contribution . . . should be even less” than it had been in the past (Rovner, 1997, p. 56). Between 1998 and 1999, employment-based insurance expanded as the economy grew stronger and unemployment declined, but since the economic downturn in 2001, employment-sponsored coverage has declined significantly each year. The percent of Americans with employment-based coverage fell from 61.3 to 60.4 percent between 2002 and 2003, and in 2010 reached a new low of 55.3 percent (Kaiser Commission, 2004; U.S. Bureau of Census, 2007; DeNavas-Walt, 2011). Even more disturbing, low-wage workers lost enormous ground. Schmitt (2012) found that only 25 percent of low-wage workers (defined as those in the bottom 20 percent of hourly wages) had insurance through their employers in 2010.
