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In U.S., Employer-Based Health Insurance Declines Further

In U.S., Employer-Based Health Insurance Declines Further

by Elizabeth Mendes

WASHINGTON, D.C. -- Forty-five percent of American adults reported getting their health insurance from an employer in January through May of this year. This is down from 45.8% in 2010, and has been steadily declining since Gallup and Healthways started tracking health insurance sources in 2008.

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The 25.3% of adults who so far in 2011 say they have government health insurance -- Medicare, Medicaid, or military/veterans' benefits -- is unchanged from 2010, although still significantly higher than in 2009 and 2008. The percentage of uninsured Americans -- which initially increased in 2009 -- continues to creep up and is at 16.6% in 2011.

Blacks Among Most Likely to Report Decline in Employer-Based Health Coverage

Employer-based health insurance is down across all major demographic groups in 2011 compared with 2008. However, it has decreased the most among blacks (6.5 percentage points), those aged 27 to 35 (6.2 points), and those with an annual income between $36,000 and $89,999 (6.1 points).

Several other groups also showed above-average declines in employer-based health insurance, including Americans who are not college educated, those between the ages of 36 and 44, low-income adults, Southerners, Hispanics, and men.

High-income and highly educated Americans -- who have been the most likely to get their health insurance from an employer every year since 2008 -- were among the least likely to report a decline.

However, the two groups least likely to have employer-based health insurance -- seniors, who at the age of 65 qualify for Medicare, and 18- to 26-year-olds -- were also among the least affected by the drop-off in employer-based healthcare.

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Bottom Line

The issue of health insurance in the United States is far from fading into the background. Currently, 26 states are seeking to overturn the new healthcare law in court. At the same time, nearly every state is scrambling to figure out to how to fund and implement the law amid tough economic times and congressional lawmakers are debating the future of Medicare and Medicaid. The confluence of these issues makes who is covered and how they get their coverage more relevant than ever.

There are two major forces that are affecting where Americans get their health coverage: One is President Barack Obama's Patient Protection and Affordable Care Act and the other is high unemployment and underemployment. As only certain parts of the new healthcare law have been implemented, the latter issue appears to be the more influential one at this time, with steady declines since 2008 in the percentage of Americans who get their health insurance from an employer.

About the Gallup-Healthways Well-Being Index

The Gallup-Healthways Well-Being Index tracks U.S. and U.K. well-being and provides best-in-class solutions for a healthier world. To learn more, please visit

Survey Methods

Results are based on telephone interviews conducted as part of the Gallup-Healthways Well-Being Index survey Jan. 2-May 31, 2011, with a random sample of 147,291 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia, selected using random-digit-dial sampling.

For results based on the total sample of national adults, one can say with 95% confidence that the maximum margin of sampling error is ±1 percentage point.

Interviews are conducted with respondents on landline telephones and cellular phones, with interviews conducted in Spanish for respondents who are primarily Spanish-speaking. Each sample includes a minimum quota of 400 cell phone respondents and 600 landline respondents per 1,000 national adults, with additional minimum quotas among landline respondents for gender within region. Landline telephone numbers are chosen at random among listed telephone numbers. Cell phone numbers are selected using random-digit-dial methods. Landline respondents are chosen at random within each household on the basis of which member had the most recent birthday.

Samples are weighted by gender, age, race, Hispanic ethnicity, education, region, adults in the household, and phone status (cell phone only/landline only/both, cell phone mostly, and having an unlisted landline number). Demographic weighting targets are based on the March 2010 Current Population Survey figures for the aged 18 and older non-institutionalized population living in U.S. telephone households. All reported margins of sampling error include the computed design effects for weighting and sample design.

In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

For more details on Gallup's polling methodology, visit

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