State-Level Trends in Employer-Sponsored Health Insurance

Research from the University of Minnesota’s State Health Access Data Assistance Center (SHADAC) shows the percentage of private sector workers who receive health insurance through their employers has fallen significantly since the early 2000s, a trend accelerated since the Great Recession.

The Issue

Employer-sponsored insurance has dropped from 53.7 percent in 2009 to 49.7 percent in 2013. Prior to the recession, the research shows that employer coverage was fairly stable, but that more workers were declining their employers’ offers of insurance and after the recession, fewer employers offered insurance to their employees.

Key Findings

  • Fewer employers offer insurance to their workers. Nationally, the percentage of private-sector employers offering coverage fell nearly 6 percentage points—from 55.7 percent in 2005 to 50.0 percent in 2013.

  • Prior to the recession, employer coverage was stable but more workers were declining their employers’ offers of insurance. Nationally, the percentage of workers who took up employer-offered coverage fell from 79.7 percent in 2005 to 77.8 percent in 2009.

  • Post-recession, workers’ take-up of coverage fell further to 75.3 percent in 2013, along with declines in employer offers of coverage (from 55.7 percent in 2009 to 50.0 percent in 2013) and the percentage of workers eligible to sign up for coverage (which fell from 78.8 % to 77.8 %).

  • Costs of insurance premiums continue to rise. Nationally, the average annual premium for employee-only coverage increased from $3,848 in 2005 to $5,478 in 2013. Family premiums increased from $10,367 on average to $16,302 during the same time period.


The report serves as important context for understanding the effects that the Affordable Care Act will have on employer coverage. The researchers say that it will be important to keep in mind that other factors such as the economy also affect employer coverage and that these need to be considered in analyzing the Affordable Care Act’s impacts.

About the Grantee

The State Health Access Data Assistance Center (SHADAC) is an independent health policy research center located at the University of Minnesota School of Public Health. SHADAC is a resource for helping states collect and use data for health policy, with a particular focus on monitoring rates of health insurance coverage and understanding factors associated with insurance. SHADAC is primarily funded by the Robert Wood Johnson Foundation.