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This issue brief focuses on how employer-sponsored insurance (ESI) coverage has changed among employees. It begins with a brief description of major forces driving ESI: changes in the workforce and the rising costs of health insurance over the four year period. Next, it examines the decline in ESI among employees and the underlying reasons determining whether an employee has ESI, specifically: employer sponsorship of ESI, employee eligibility, employee participation, and employee participation in ESI available through another family member's job. The issue brief concludes by examining how the reasons for the decline in ESI varied across different groups of employees.