Blog & News
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.
SHADAC Expertise
Federal Survey Data Release Schedule
American Community Survey (ACS)
An ongoing general household survey conducted by the U.S. Census Bureau provides annual estimates of health insurance coverage at the national, state, and sub-state geographies.
Upcoming Releases
September 12, 2024
• 2023 ACS 1-year Data
October 17, 2024
• 2023 ACS 1-Year Public Use Microdata Sample (PUMS) Files
December 12, 2024
• 2019-2023 5-Year Data
January 23, 2025
• 2019-2023 5-Year Public Use Microdata Sample (PUMS) Files
Previous Year Releases
September 2023
• 2022 ACS 1-year Data
October 2023
• 2022 ACS 1-Year Public Use Microdata Sample (PUMS) Files
November 2023
• 2018-2022 5-Year Public Use Data
January 2024
• 2018-2022 5-Year Public Use Microdata Sample (PUMS) Files
Other Resources
• An Assessment of the COVID-19 Pandemic’s Impact on the 2020 ACS 1-Year Data Analytic Paper
• Introduction to the American Community Survey Public Use Microdata Sample (PUMS) file
Current Population Survey (CPS)
A monthly household survey conducted by the U.S. Census Bureau for the Bureau of Labor Statistics. Data on income and health insurance coverage is collected in its Annual Social and Economic Supplement administered in February through April. Annual health insurance estimates are provided for the nation and states.
Upcoming Release
September 12, 2024
• 2023 Income, Poverty and Health Insurance statistics from the Current Population Survey Annual Social and Economic Supplement (CPS ASEC)
Previous Year Release
September 12, 2023
• 2022 Income, Poverty and Health Insurance Statistics from the Current Population Survey Annual Social and Economic Supplement (CPS ASEC)
Medical Expenditure Panel Survey (MEPS)
MEPS is a two-component survey sponsored by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality. The MEPS-Insurance Component (IC) is a survey of employers that provide data on employer-based health insurance. The MEPS-Household Component (HC) is a panel household survey that is supplemented with data from the respondents' medical providers.
Upcoming Releases
July 2024
• 2023 MEPS-IC Private Sector Tables - National Estimates
• 2023 MEPS-IC Private Sector Tables - State Estimates
• 2023 MEPS-IC Private Sector Tables -Metro Estimates
October 2024
• 2023 MEPS-IC Chartbook 2023
November 2024
• 2019-2022 MEPS Panel 24 (COVID Panel) Longitudinal Data File
Previous Year Releases
July 2023
• 2022 MEPS-IC Private Sector Tables - National Estimates
• 2022 MEPS-IC Private Sector Tables - State Estimates
• 2022 MEPS-IC Private Sector Tables - Metro Estimates
National Health Interview Survey (NHIS)
A continuous cross-sectional household interview survey conducted by the National Center for Health Statistics (NCHS) which is part of the Centers for Disease Control and Prevention (CDC). It provides information on the health of the U.S. population and includes questions about health insurance coverage, health care utilization and access, and health conditions and behaviors, in addition to demographic and socioeconomic characteristics.
Estimates for sub-annual time periods are released through the NHIS Early Release Program in September, November/December, and February/March each year.
Current Release
Previous Releases
June 2023
• 2022 NHIS Public Use Files
Behavioral Risk Factor Surveillance System (BRFSS)
A state-based survey sponsored by the Centers for Disease Control and Prevention that focuses on population health, risk factors, and health behaviors for the adult population.
Upcoming Release
August 2024
• 2023 Annual Survey Data
Previous Year Release
August 2023
• 2022 Annual Survey Data
Household Pulse Survey
A near-real-time experimental survey from the U.S. Census Bureau. Typically released on a monthly basis.
Upcoming Release
June 13, 2024
• Phase 4.1 Survey Data
Page last updated June 2024
Publication
SHADAC's 2020 Health Insurance Unit and Updated Defining Families Issue Brief
In 2012, SHADAC created and released the SHADAC “Health Insurance Unit,” or “HIU,” to aid researchers in reconciling the differences between the way that a “family” is defined in federal surveys (such as the U.S. Census Bureau’s American Community Survey [ACS] or Current Population Survey [CPS]) with the way a “family” is defined by most private and public insurance programs, specifically for the purposes of analyzing health insurance coverage. The SHADAC HIU has been updated over time and has now been updated again in response to changes to policy and program eligibility rules.
To support the use of the SHADAC HIU we have developed three products:
2020 Update of SHADAC’s Health Insurance Unit (July 2020): An issue brief that describes the SHADAC HIU, its purpose, the most recent update, and improvements to HIU data inputs made available by IPUMS.
*RECENTLY UPDATED* Defining Family for Studies of Health Insurance Coverage (July 2023): A brief that outlines the impacts of using the SHADAC HIU in analysis—specifically, analysis showing how the population distribution of family income changes using three different definitions of family: all members in the same household (Census definition), the definition used by the IPUMS (described below), and the SHADAC HIU (described in detail in a companion brief). Researchers can use this brief to assess whether the SHADAC HIU is suitable for their analysis and what the potential impacts of its use might be.
Stata Code (January 2021): Technical documentation of statistical code in STATA and SAS to help researchers to employ the SHADAC HIU in their own analysis using ACS microdata downloaded from IPUMS USA.
Archived documentation from previous versions of the SHADAC HIU include:
"Defining Family for Studies of Health Insurance Coverage" August 2021
"Using SHADAC Health Insurance Unit (HIU) and Federal Poverty Guideline (FPG) Microdata Variables" November 2013
"Defining “Family” for Studies of Health Insurance Coverage" March 2012
For questions about the SHADAC HIU or to receive technical assistance regarding its use, please feel free to contact SHADAC analysts at shadac@umn.edu