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Health Insurance

Fewer North Carolinians Have Job-Based Insurance


By Taylor Sisk

A steady job offers less piece of mind than it once did.

According to data released earlier this month the percentage of nonelderly North Carolinians with employer-sponsored health insurance dropped from 69.3 percent in 1999/2000 to 56 percent in 2010/2011. In only four states – Michigan, South Carolina, Indiana and Ohio – did that rate drop more precipitously.

The country as a whole dropped from 69.7 percent to 59.5 percent.

In addition to higher unemployment, a number of employment-related factors contributed to the decline in employer-sponsored insurance (ESI) coverage. The report, produced by the State Health Access Data Assistance Center (SHADAC) for the Robert Wood Johnson Foundation, examined a number of factors, including:

  • the percentage of employers that offer ESI
  • the percentage of workers  employed by companies that offer ESI
  • the percentage of workers eligible for ESI at employers that offer coverage
  • take-up of ESI among eligible employees
  • self-insurance
  • premium costs

The percentage of employers in North Carolina offering insurance dropped by 9.5 percentage points, from 59.4 to 49.9. The national average fell from 58.9 to 52.4.

While 47 states and the District of Columbia experienced significant declines in ESI coverage, the numbers varied considerably from state to state.

Michigan experienced the steepest decline, at 15.2 percent; Nebraska experienced the smallest, at 4.3 percent. New Hampshire had the highest rate of nonelderly residents with ESI coverage in 2010/2011, with 73.8 percent; New Mexico had the lowest, at 48 percent.

Elderly are not counted because they’re eligible for Medicare once they reach the age of 65.

‘Ongoing downward shift’

“The story of ESI coverage is one of income as well, since the likelihood of having ESI coverage increases as a person’s income increases,” the report’s authors wrote.

In 2010/2011, 88 percent of nonelderly Americans with a household income at or above 400 percent of the Federal Poverty Guideline ($89,400 annually for a family of four) were covered by their employer.

Only 29.2 percent of those with a household income below 200 percent of FPG ($44,700 annually for a family of four) were covered.

And lower-income households were disproportionately affected over the time period of the study. The rate of job-sponsored coverage for working-age people in households with incomes at or above 400 percent of FPG dropped just 2.8 percent, while coverage for the nonelderly in households with income below 200 percent of FPG fell 10.1 percent.

In North Carolina, the number of nonelderly residents at or above 400 percent of the FPG with coverage dropped 5.9 percent; those below 200 percent of the FPG dropped 12.5 percent.

“The effects of this disproportionate decline of ESI coverage at lower income levels are exacerbated by an ongoing downward shift in the distribution of household income since 1999/2000,” the authors wrote.

As for those who did have employer-sponsored insurance: While the average employee’s share of the premium held relatively constant for both single and family coverage, a rise in total premium cost resulted in the average employee’s contribution jumping from $435 to $1,056 for single coverage and from $1,526 to $3,842 for family coverage.

U.S. Census data shows that during the same time period, median income for working-age households fell 12.4 percent.

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  • Mr_McBud

    Good – Health insurance should be like car or home insurance – that is, not related whatsoever to one’s employment.

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