Job-based health insurance in the balance: employer views of coverage in the workplace.

H istorically, employers have been the primary source of health insurance coverage for working-age Americans and their dependents.Yet according to a recent survey of 453 employers, the job-based health system is under stress.The Commonwealth Fund Supplement to the 2003 National Organizations Study (NOS) finds that double-digit increases in health insurance premiums led employers to shift more of their health care costs to employees in 2002–03. But the survey also finds that most employers who offer health insurance see it as a core part of their compensation packages— a benefit that improves morale and productivity and makes it easier to recruit and retain employees. Employers voice strong support for many recent health reform proposals made by federal and state policy leaders to expand insurance coverage, including proposals that would require them to make financial commitments. The findings also point to a stark divide in the quality of U.S. jobs: employers who do not offer health coverage tend not to offer other benefits, such as paid sick leave, that many workers take for granted. Moreover, firms that do not offer their employees benefits more often have lower-wage workforces. Based on the survey findings, employers appear willing to consider new public–private policies to increase the availability of affordable coverage, measures that would go a long way toward bridging the divide in the quality of U.S. jobs. For more information about this study, please contact: