A new report from EBRI examines long-term trends in employer offers of health benefits and worker eligibility for coverage. Among the key findings:

Employer sponsorship. The percentage of employers offering health benefits ebbed and flowed from 1996-2024. After a near-record low of 46.3% in 2023, the percentage of employers offering health benefits increased slightly to 49%. Declines have been concentrated among small employers, while large employer sponsorship has remained stable.
Eligibility rates. Despite small-employer sponsorship declines, worker eligibility for health benefits has stayed mostly constant since 1996, ranging from 75%-81%. In 2024, 80% of private-sector workers were eligible for health benefits, reflecting the dominance of large employers, which employ about two-thirds of all workers.
Coverage trends. The percentage of the non-elderly population with employment-based health benefits was at or near 70% from 1970-89. By 2024, 61% of the non-elderly population had employment-based health coverage. Employment-based coverage remains the most common source of health coverage among the non-elderly population.
Labor market shifts. The percentage of workers employed full time rose from 63% in 2014 to 69% in 2024. After a long-term decline, the share of firms with mostly low-wage work forces ticked up from 15% in 2023 to 21% in 2024. The share of workers in large firms increased slightly, from 65% in 2013 to 67% in 2024.

The rising cost of health care is expected to remain a concern for all workers, regardless of their employer's size.

Instant Insights /

Why are fewer small employers offering health coverage?