Though a rebounding economy and the Affordable Care Act’s insurance mandate have boosted the overall number of people enrolled in coverage through their employer, long-term trends show a notable decline in enrollment, according to a new study.
Researchers at the Kaiser Family Foundation found that 58.4% of people in 2017 were enrolled in an employer-sponsored plan, up from 56.3% in 2013.
However, despite the uptick, it’s still significantly lower than the 67.3% of people who were covered by their employers in 1999, according to the study.
“Despite a recent, favorable period, there is no evidence to suggest that the share of nonelderly people covered by employer-based plans will ever approach past levels,” the foundation’s researchers said in the report.
KFF found that 156.3 million people were covered by employer plans in 2017, compared to 159.4 million in 1999. However, to account for population growth, that means that 24 million more people would need to be enrolled in these plans to gain the same coverage levels.
Employer-sponsored insurance still accounts for the largest share of coverage nationwide, but that is eroding, according to the study, particularly among low-income workers.
Despite these trends, the uptick after 2013 is a positive sign, the study said. For one, it highlights that employment and incomes have rebounded significantly from the recession in 2008 and 2009.
The ACA’s mandate that individuals be covered and that employers offer coverage also likely played a key role, KFF said, particularly for low-wage workers who may not have previously qualified for insurance.
Smaller employers who were not subject to the ACA’s mandate, however, were more likely to drop coverage options, according to the study, especially with the subsidies available in the individual markets.
Though in 2014 and 2015—the early days of the ACA exchanges—options were robust, rising premiums and fewer coverage options in recent years may be another factor driving people into employer plans.
“Given the continuing economic improvement, it is quite possible that some of these people moved into employer-based plans,” the researchers said.