VISIT STATE HEALTH COMPARE
Publication
A Post-Pandemic Look at the Cost of Employer-Sponsored Insurance (ESI) Coverage: Data from the 2023 Medical Expenditure Panel Survey (MEPS)
This post is a part of our Survey Data Season series where we examine data from various surveys that are released annually from the summer through early fall. Find all of the Survey Data Season series posts on our Survey Data Season 2024 page here.
Over the past five years, the makeup of the health insurance coverage marketplace in the United States has changed considerably due in large part to the COVID-19 related public health emergency (PHE) and its effects, both immediate and delayed. The arrival of the coronavirus caused an unprecedented spike in unemployment which, for those affected, led to a resultant loss of employer-sponsored health insurance coverage – also commonly referred to as employer-sponsored insurance, or ESI.
These losses were at least partially offset by rising enrollment in and retention of public health insurance coverage like Medicaid under the continuous coverage requirement in the Families First Coronavirus Response Act (FFCRA). However, this requirement has now ended, and states have officially completed the transition to restart standard redetermination and enrollment procedures, a period commonly known as the “Medicaid unwinding,” or simply, the “unwinding.”
Preliminary data from states and federal sources like the Household Pulse Survey (HPS) suggests a potential recovery for ESI enrollment in the coming years, a trend that SHADAC will continue to monitor.
New ESI Report from SHADAC
A new report from SHADAC researchers Andrea Stewart and Robert Hest uses estimates from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC), produced by the Agency for Healthcare Research and Quality (AHRQ), to look at national and state-level ESI data in 2023 with 2022 as a comparison.
Despite pandemic-related decreases, ESI still represents the primary source of health insurance coverage for a majority of the U.S. population (54.7%, or approximately 182.3 million people in 2023), and it important to understand how trends in coverage and, most importantly, cost, have changed in the emergence from the pandemic and in the months post-continuous coverage requirement.
ESI cost-related factors included in the report are:
- Premiums (single and family)
- Deductibles (single and family), and
- Enrollment in high-deductible health plans (HDHPs)
Accompanying this narrative are detailed 50-state comparison tables that allow for easy cross-state analysis of ESI trends from 2019 to 2023, significant changes in ESI rates from 2022 to 2023, and state vs national average comparisons for 2023 estimates.
Find the full report here, and the 50-state comparison tables below.
Looking for more resources on health insurance coverage and cost? Check out some of the following SHADAC resources:
- Blog: 2023 NHIS Full-Year Health Insurance Estimates Early Release: Decreasing Uninsured Rates Overall and for Certain Groups of Nonelderly Adults
- Blog and Infographic: CPS ASEC: 2023 National Health Insurance Coverage Estimates Remain Steady for Adults but Rise for Children
- Blog: 2023 ACS: After Two Years of Decline, Uninsured Rates Increased for Children; Public and Private Coverage Rates See Variations Across the States
Publication
WEBINAR: U.S. Census Bureau Data Explained: Breaking Down 2023 Health Insurance Coverage Estimates from the ACS & CPS - featuring a Q&A with a Census Bureau Expert
This presentation is a part of our Survey Data Season series where we examine data from various surveys that are released annually from the summer through early fall. Find all of the Survey Data Season series posts on our Survey Data Season 2024 page here.
On Thursday, September 26th at 1:00 PM CST, SHADAC hosted a webinar covering the release of new Census data on health insurance coverage estimates for 2023. The estimates come from two key federal surveys conducted by the U.S. Census Bureau: The American Community Survey (ACS) and the Current Population Survey (CPS).
SHADAC researchers and presenters Robert Hest and Andrea Stewart discussed the 2023 health insurance data at national and state levels, as well as by coverage type, and a range of other demographic categories (age, geography, poverty level, and more). In addition, SHADAC walked through how to access the data and examples of how to use it to answer research questions. We were also pleased to once again welcome a special guest from the Census Bureau, Sharon Stern, who joined the end of the webinar to participate in a Q&A, answering questions from attendees.
Webinar attendees came away knowing more about:
- The new 2023 health insurance coverage estimates
- How to access the estimates via Census reports and the data.census.gov website
- How to access state-level estimates from the ACS using SHADAC’s State Health Compare web tool
- When and how to use 2023 Census data to understand health insurance coverage trends
Find a recording of this webinar, along with presentation slides and a transcript of webinar audio, below.
Find the slides from this presentation here. Find a transcript of this webinar here.
Speakers
Elizabeth Lukanen, Moderator
Deputy Director, SHADAC
Ms. Lukanen serves as the Deputy Director for SHADAC, overseeing center research and providing strategic direction and oversight. With 20 years of experience in the health policy arena, Ms. Lukanen specializes in managing complex projects and translating quantitative findings into actionable, policy-relevant information. Ms. Lukanen currently oversees SHADAC’s technical assistance to states in the areas of data use, analysis, and evaluation. Ms. Lukanen is vocal about the importance of collecting and reporting disaggregated data to explore issues related to health equity, while actively working with policymakers to improve data on race, ethnicity, sexual orientation, and gender identity.
Robert Hest, Speaker
Senior Research Fellow, SHADAC
Robert Hest joined SHADAC in 2017, providing expertise in survey data, quantitative data analysis, data visualization, and health coverage policy. Mr. Hest leads SHADAC’s work monitoring and investigating developments in the measurement of health insurance coverage and health care access, affordability and utilization in federal survey data. He also manages SHADAC’s State Health Compare website, coordinating data processing, quality assurance, dissemination, and documentation of data used on the site and leads SHADAC’s work in the Minnesota Research Data Center applying restricted-use data to analyze health care affordability, access, and utilization at the state level.
Andrea Stewart, Speaker
Research Fellow, SHADAC
Andrea Stewart joined SHADAC in 2018 as a Marketing and Communications Specialist, transitioning to a Research Fellow in 2022. Currently, Ms. Stewart leads SHADAC’s efforts to track and report health insurance coverage data from major federal surveys, and is involved in several other ongoing projects, including an effort to explore the potential for the creation of a Medicaid Equity Monitoring Tool. Portions of her other research work range in topic from health equity measurement to understanding the impacts of COVID-19 on federal survey data.
Sharon Stern, Speaker
Assistant Division Chief, U.S. Census Bureau
Sharon Stern is the Assistant Division Chief for employment characteristics in the U.S. Census Bureau’s Social, Economic and Housing Statistics Division. In her position, Ms. Stern oversees statistics on the labor force, health insurance and disability from several Census Bureau surveys. She has authored a wide variety of Census Bureau reports and papers on topics related to poverty, disability, and health insurance.
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Publication
Comparing Federal Government Surveys That Count the Uninsured: 2023
SHADAC has recently updated our annual “Comparing Federal Government Surveys that Count the Uninsured” brief following the release of new insurance coverage estimates from surveys conducted by the US Census Bureau, the Agency for Healthcare Research and Quality (AHRQ), and the Centers for Disease Control and Prevention (CDC).
Accurate estimates of the number of people that do not have insurance coverage (also referred to as uninsured or uninsurance) are important in understanding trends and the impacts of actions (policy changes), events (like public health emergencies), or shifts in the economic landscape (like periods of recession) that may affect health insurance coverage.
The brief provides an annual update to comparisons of uninsurance estimates from five federal surveys. As in prior years, we have included estimates from:
- The American Community Survey (ACS)
- The Current Population Survey (CPS)
- The Medical Expenditure Panel Survey - Household Component (MEPS-HC)
- The National Health Interview Survey (NHIS)
View and download the Comparing Federal Government Surveys 2023 Brief to learn more about our findings and analysis.
Blog & News
Hest, Robert
Theis, Lindsey
Exploring Cost and Coverage Rates in Employer-Sponsored Insurance (Infographic)
September 5, 2023:Throughout the United States, a majority of Americans and their families receive health insurance coverage through their employer. In 2021, the number of people covered by this type of coverage—known as employer-sponsored insurance or ESI—exceeded 169 million. While a fuller picture of the coverage landscape will be available later this fall as agencies such the U.S. Census Bureau release more health insurance data, in this blog and infographic, SHADAC researchers use recently released data from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) to analyze private-sector ESI and provide an initial snapshot of estimates for 2022 on a national level and within the states.
Key Findings (2022 vs. 2021)
Employee Access to Coverage
- The offer of employer-sponsored insurance coverage was extended to a large majority of private-sector workers. In 2022, 85.6% of employees in the U.S. worked in establishments that offered health insurance coverage, a rate that was statistically unchanged from 2021 (85.7%).
Employee Coverage Costs
Premiums
- The average annual premium for single coverage significantly increased to $7,590 in 2022, a $210 or 2.8% increase from 2021.
- Among the states, average annual single premiums ranged from $6,713 in Oklahoma to $8,936 in New York.
- For those enrolled in family coverage, average annual premiums also significantly increased. In this case, premiums increased to $21,931 in 2022, a $550 or 2.6% increase from 2021.
- Among the states, average annual family premiums ranged from $19,003 in Oklahoma to $25,892 in Alaska.
Deductibles
- For single coverage, the 2022 average individual deductible was $1,992, unchanged from 2021 ($2,004).
- Among the states, average individual deductibles ranged from $1,343 in D.C. to $2,771 in Maine.
- Among those enrolled in family coverage, the average deductible per employee enrolled was $3,811 in 2022. This was also unchanged from 2021 ($3,868).
- Among the states, average family deductibles ranged from $3,009 in D.C. to $4,858 in South Dakota.
High-Deductible Health Plans*
- In 2022, the share of employees enrolled in high-deductible health plans (HDHPs) decreased significantly in 2022 to 53.6% – a decrease of 2.1 percentage points from 2021.
- Among the states, the percent of private-sector employees enrolled in high-deductible health plans ranged from 21.8% in Hawaii to to 72.2% in South Dakota.
Key Takeaways
With so many Americans relying on an employer for health insurance coverage, measures of ESI coverage and cost remain important indicators of the financial and health burdens many individuals and families face. These measures will be of greater importance going forward as some current Medicaid enrollees may transition to employer coverage during the 2023-2024 unwinding of the Medicaid continuous coverage requirement. SHADAC is monitoring the unwinding process through a variety of avenues, including: federal surveys, state dashboards, and state-based marketplace data.
In 2022, as in previous years, premiums continued to rise, though premium increases were small compared to the relatively high rate of inflation in 2022. Average deductibles were unchanged from 2021, which represents a break from the long-running trend of increasing deductibles. Additionally, the share of private sector employees enrolled in high-deductible plans decreased by a small but statistically significant margin, which represented the first decrease since 2013. With regard to coverage, a large majority of workers were employed in establishments that offered health insurance coverage, and this was unchanged from 2021.
Notes and Sources
* High-deductible health plans (HDHP) are defined as plans that meet the minimum deductible amount required for Health Savings Account (HSA) eligibility ($1,400 for an individual and $2,800 for a family in 2022).
Data are from the 2022 Medical Expenditure Panel Survey–Insurance Component (MEPS-IC), produced by the Agency for Healthcare Research and Quality (AHRQ).
Health insurance coverage estimates through 2021 are available on SHADAC’s State Health Compare web tool at statehealthcompare.shadac.org, and estimates for 2022 will be added soon.
Publication
Comparing Federal Government Surveys That Count the Uninsured: 2022
With the release of new insurance coverage estimates from surveys conducted by the U.S. Census Bureau, the Agency for Healthcare Research and Quality (AHRQ), and the Centers for Disease Control and Prevention (CDC), SHADAC has updated our annual “Comparing Federal Government Surveys that Count the Uninsured” brief.
The brief provides an annual update to comparisons of uninsurance estimates from four federal surveys:
- The American Community Survey (ACS)
- The Current Population Survey (CPS)
- The Medical Expenditure Panel Survey - Household Component (MEPS-HC)
- The National Health Interview Survey (NHIS)
In this brief, SHADAC presents current and historical national estimates of uninsurance along with the most recent available state-level estimates from these surveys (where possible). We also discuss the main reasons for variation in the estimates across the different surveys as well as possible reasons for incomparability of estimates across and within the surveys.
Download a PDF of the Comparing Federal Government Surveys Brief.
Last year’s brief with data from the 2020 collection year, and certain 2019 collection-year data, can be accessed here.
