State-by-State Employer-Sponsored Insurance Access, Affordability, and Enrollment in 2018

These state appendices illustrate access to, affordability of, and enrollment in employer-sponsored insurance (ESI) in 2018 for workers in private-sector establishments likely to be in families with low incomes. Using information from the Medical Expenditure Panel Survey Insurance Component, we provide state and national estimates and test whether state patterns differ from those in the rest of the country. Understanding access to, affordability of, and enrollment in ESI coverage is critical to developing policies that minimize gaps in health insurance coverage and access to needed care among low-income workers and their families.

Our analysis indicates that certain groups of workers across states, particularly those working part time or for a small firm, did not have access to ESI in 2018, and those with access likely faced affordability barriers because of the magnitude of the premiums and deductibles for such coverage. The ESI coverage available at many private-sector establishments across states would require significantly higher employee premium contributions and include higher deductibles relative to what is available to people with low incomes who qualify for Marketplace coverage under the Affordable Care Act.

For information on our data and methods, along with the full 50-state analysis of ESI among workers in families with low incomes, see Employer-Sponsored Insurance Access, Affordability, and Enrollment in 2018: State and National Estimates and Implications for Low-Income Working Families.