Trends in Enrollment, Offers, Eligibility and Take-Up for Employer-Sponsored Insurance

MEPS Statistical Brief, No. 499

Trends in Enrollment, Offers, Eligibility and Take-Up for Employer-Sponsored Insurance, a statistical brief from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC), uses data for private-sector establishments to compare employer-sponsored insurance (ESI) trends across States that expanded Medicaid (expansion States), and States that did not expand Medicaid (non-expansion States).

From 2008 to 2015, the percentage of U.S. private-sector employees enrolled in a health insurance plan offered by their employer (enrollment rate) fell from 53.9 percent to 47.8 percent. Declines in the percentage of employees who worked in an establishment that offered insurance (offer rate), the percentage of workers in offering establishments who were eligible for insurance (eligibility rate), and the percentage of eligible workers who enrolled in offered coverage (take-up rate), all contributed to the 6.1 percentage point drop in the enrollment rate. In spite of the steady decline from 2008 to 2015, ESI remains the primary source of health insurance coverage for individuals under age 65.

The passage of the Affordable Care Act in March 2010, provided an additional source of health insurance for many non-elderly adults, by expanding Medicaid eligibility to adults with incomes up to 138 percent of the Federal poverty level. By the end of 2015, 29 States and the District of Columbia had expanded Medicaid, with the majority 20 States expanding Medicaid eligibility on January 1, 2014. Expanded Medicaid eligibility may alter employers' incentives to offer insurance and employees' incentives to enroll in offered coverage.

Highlights:

  • From 2008 to 2015, the enrollment rate fell in both groups of States, but the decline was more rapid in expansion States than in non-expansion States (7.1 versus 4.5 percentage points).
  • The decline in the eligibility rate in expansion States (from 2008 to 2015) accounts, in part, for the more rapid decline in enrollment rates in expansion States compared to non-expansion States.
  • The larger decline in the take-up rate in expansion States than in non-expansion States also accounts for part of the differential trends in enrollment rates observed for expansion and non-expansion States.

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Page last reviewed February 2017
Page originally created October 2015
Internet Citation: Trends in Enrollment, Offers, Eligibility and Take-Up for Employer-Sponsored Insurance. Content last reviewed February 2017. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/meps.html