Health care increasingly unaffordable for people, especially women, with employer-sponsored insurance

Access to employer-provided health insurance does not always translate to affordable health care.

“In recent years, employer-sponsored health insurance has become less adequate in providing financial protection for all kinds of health care services,” says Avni Gupta, a doctoral student in the Department of Public Health Policy and Management at the NYU School of Global Public Health. Gupta was the lead author of an analysis by researchers at the school that was reported in the Journal of the American Medical Association.

More than 6 in 10 working-age adults in the United States as of 2019 obtained health insurance coverage through their employers. Despite improvements in employer-sponsored insurance by the Affordable Care Act, health care costs and out-of-pocket expenditures have continued to rise, the study finds.

Using the National Health Interview Survey, a nationally representative annual survey conducted by the Centers for Disease Control and Prevention, researchers analyzed data from 2000 to 2020 for more than 238,000 adults aged 19 to 64 years who obtained their health care coverage through an employer or union.

Women with employer-sponsored insurance found all types of health care services to be less affordable than for men. On average:

• 9% of women and 2.7% of men report that medical care was unaffordable;
• 1% of women and 5.4% of men say dental care was unaffordable;
• 2% of women and 2.7% of men say prescription medications were unaffordable; and
• 1% of women and 0.8% of men report that mental health care was unaffordable.

“Lower incomes and higher health care needs among women could be driving these differences in reported affordability,” Gupta says. “Employer-sponsored insurance plans need to redesign their benefit packages to reduce sex-based disparities.”

Over the two decades studied, both women and men found nearly all health care services to be less affordable in recent years compared to in the early 2000s (although affordability for some services improved in certain years). Approximately 6% of women found medical care unaffordable in 2020 compared to 3% in 2000, and roughly 3% of men say medical care was unaffordable in 2020 compared to 2% in 2000.

Related: Looking for affordable quality health care in the U.S.? Check out these 10 states.

“People with health insurance coverage provided by employers generally think they are protected, but our findings show that health-related benefits have been eroding over time,” says José A. Pagán, professor and chair of the Department of Public Health Policy and Management at the NYU School of Global Public Health and co-author of the analysis.