This paper analyzes what is likely to happen to low- and middle-income workers that lose access to ESI. Low- and middle-income workers have fewer other options for coverage. The study examined the share of workers with access to ESI through a spouse, the cost of purchasing nongroup insurance relative to income, and eligibility for public programs. It found 50 percent of low-income workers and 20 percent of middle-income workers have no affordable insurance options outside the ESI market. According to the authors, 43 percent of low-income workers and 31 percent of middle-income workers would become uninsured if ESI were no longer available to them.