“Quite a lot of instances, well being care comes with a job.”
Sen. John Thune (R-S.D.), in an interview with KOTA on Could 30, 2025
Hundreds of thousands of individuals are anticipated to lose entry to Medicaid and Reasonably priced Care Act market medical insurance plans if federal lawmakers approve the One Large Stunning Invoice Act, President Donald Trump’s home coverage bundle, which is now transferring by means of the Senate.
Senate Majority Chief John Thune mentioned well being care and the pending laws in an interview with KOTAa South Dakota TV station. However he targeted on a unique type of medical insurance — employer-sponsored insurance coverage.
“Quite a lot of instances, well being care comes with a job,” Thune stated.
Thune’s feedback within the interview had been made within the context of highlighting a part of the GOP’s financial coverage goal. “Creating these better-paying jobs that include advantages is in the end the purpose right here,” he stated.
KFF Well being Information reached out to Thune’s workplace to seek out out the idea for this remark. His communications director, Ryan Wrasse, responded by reiterating Thune’s message: “Getting a job has the potential to guide a employee to buying well being care.”
Paul Fronstin, director of well being advantages analysis on the Worker Profit Analysis Institute, stated Thune’s remark may be alluding to discussions surrounding Medicaid work necessities. The One Large Stunning Invoice Act would let nondisabled adults enroll in Medicaid provided that they show they’re volunteering, working, or looking or coaching for work.
Medicaid, funded by the federal authorities and states, is the nation’s primary medical insurance program for folks with low incomes. Some folks with disabilities additionally qualify.
Some Republicans have constructed on the roles speaking level in defending the Medicaid cuts and work necessities. Sen. James Lankford (R-Okla.), as an example, advised CNBC the invoice isn’t about “kicking folks off Medicaid. It’s transitioning from Medicaid to employer-provided well being care.”
However the well being coverage specialists we checked with made clear that getting a job isn’t a assure for getting work-sponsored insurance coverage.
Employer-Sponsored Well being Insurance coverage: The Fundamentals
These specialists stated most jobs do supply medical insurance. However in addition they stated the hyperlink between employment and work-based protection will not be all the time simple.
“Once I see this assertion, I’m like, ‘I’ve bought a lot extra to say about this.’ However I’m not arguing with the assertion,” Fronstin stated.
Matthew Rae, an affiliate director targeted on researching non-public insurance coverage at KFF, a well being data nonprofit that features KFF Well being Information, additionally weighed in.
“Employer-sponsored protection stays the bedrock of how folks get medical insurance in america,” Rae stated. “I’d say that getting a job will not be a assure you’re going to have medical insurance. It simply will increase your probabilities of getting it.”
About 60% of People youthful than 65 obtain medical insurance by means of their job or because the partner, youngster, or different dependent of somebody insured by means of their work, In keeping with 2023 KFF Knowledge.
Amongst employees ages 18 to 64 who had been eligible however didn’t join their office insurance coverage, 28% stated the explanation they determined to not enroll was that the plans had been too costly, 2023 KFF Knowledge confirmed.
Most of those employees discovered medical insurance elsewhere, similar to by means of a relative’s office plan. However a small proportion of eligible workers, 3.7%, had been uninsured.
Medical health insurance has been “essentially the most valued profit within the office” since companies started providing it to recruit workers in a decent labor market throughout World Battle II, Fronstin stated.
Federal regulation additionally encourages firms to supply plans. Below the Reasonably priced Care Act, employers with 50 or extra full-time employees are penalized in the event that they don’t supply most workers insurance coverage that the federal authorities considers reasonably priced.
As of final yr, 54% of firms supplied medical insurance to at the least some workers, in line with KFF.
However that’s not the principle approach the ACA helped decrease the speed of individuals with out medical insurance, stated Melissa Thomasson, a professor at Miami College in Ohio who specializes within the financial historical past of medical insurance. “Almost all of that” change, she stated, got here from the ACA creating non-public market plans and permitting states to develop Medicaid eligibility.
Well being coverage analysts say the One Large Stunning Invoice would make it tougher for folks to qualify or afford market plans, with proposals that may improve paperwork, shorten enrollment durations, and permit enhanced tax credit to fizzle out. Thomasson additionally famous that political rhetoric surrounding jobs and medical insurance doesn’t all the time align.
“We frequently speak about small companies being the engine of job creation,” however these are the companies that always can’t afford to supply office insurance coverage, she stated.
So Who Isn’t Insured By Office Insurance coverage?
The obvious class of people that don’t have office insurance coverage are those that don’t have a job. This group consists of kids and retirees, folks trying to find work, individuals who select to not work, and those that can’t work, due to a incapacity or sickness.
One other group with out employer-provided insurance coverage is the 25% of individuals ages 18 to 64 who’ve a job however are unable to acquire such insurance coverage, in line with 2023 Knowledge from KFF.
A few of these folks work for firms that don’t supply medical insurance. These employers are usually small companies or a part of sure industries, similar to farming and building.
Others are part-time, short-term, or seasonal employees at firms that provide medical insurance solely to full-time workers. Employees with low incomes are considerably much less seemingly than these with larger incomes to be eligible for office insurance coverage, In keeping with 2023 KFF Knowledge.
Individuals who aren’t employed or don’t get insurance coverage by means of their job can get protection in different methods. Some are insured by means of a relative’s office plan, whereas others buy plans and should qualify for subsidies on the ACA market.
Others get insurance coverage by means of Medicaid or Medicare, the federal medical insurance program for folks 65 or older and a few folks with disabilities.
Value and High quality — And Due to this fact Entry to Care — Differ
Simply because somebody has medical insurance doesn’t imply they’ll get the well being care they want. Folks might skip or delay care if their plans are unaffordable or in the event that they restrict in-network suppliers.
“Well being advantages are available all sizes and shapes,” Fronstin stated. “Some employers supply very beneficiant advantages, and others much less so.”
KFF information reveals that premiums and enrollees’ cost-sharing bills grew sooner than wages from 2008 to 2018 however have slowed in recent times.
Whether or not office insurance coverage is reasonably priced considerably varies by earnings. In keeping with 2020 KFF Knowledgelower-income households insured by means of a full-time employee spent, on common, 10.4% of their earnings on premiums and out-of-pocket prices. That’s greater than twice the speed when taking a look at households throughout all incomes.
Our Ruling
Thune stated, “Quite a lot of instances, well being care comes with a job.”
This assertion is partially correct. Most employees within the U.S. get well being protection by means of work. However it glosses over facets of our nation’s job-based medical insurance system — similar to how prices and protection, particularly for these with decrease incomes, could make an employer plan out of attain even whether it is obtainable.
Backside line: Not all jobs present medical insurance or supply plans to all their employees. After they do, price and high quality differ broadly — making Thune’s assertion an oversimplification.
We price this assertion Half True.
Sources
Interview metropolis with Sen. John Thune, Could 30, 2025.
CNBC interview with Sen. James Lankford, June 5, 2025.
KFF, ”2024 Employer Well being Advantages Survey,” Oct. 9, 2024.
KFF, ”Employer Duty Below the Reasonably priced Care Act,” Feb. 29, 2024.
KFF, ”Employer-Sponsored Well being Insurance coverage 101,” Could 28, 2024.
Peterson-KFF Well being System Tracker, ”What Are the Latest Traits in Employer-Based mostly Well being Protection?” Dec. 22, 2023.
Peterson-KFF Well being System Tracker, ”How Affordability of Employer Protection Varies by Household Revenue,”March 10, 2022.
Peterson-KFF Well being System Tracker, ”Monitoring the Rise in Premium Contributions and Value-Sharing for Households With Massive Employer Protection,” Aug. 14, 2019.
Manhattan Institute, “Put Staff in Management of Well being Insurance coverage with ‘Employee’s Alternative ICHRA,’” Could 22, 2025.
Brookings, “Uninsurance Charges Have Fallen Considerably Following the Reasonably priced Care Act,” July 22, 2024.
Harvard Enterprise Evaluation, “Why Do Employers Present Well being Care within the First Place?” March 15, 2019.
Congressional Price range Workplace letter on the One Large Stunning Invoice Act growing the variety of uninsured folks, June 4, 2025.
Cellphone interview with Paul Fronstin, director of well being advantages analysis on the Worker Profit Analysis Institute and a member of the Commonwealth Fund’s Nationwide Process Drive on the Future Position of Employers within the U.S. Well being System, June 6, 2025.
Cellphone interview with Melissa Thomasson, professor and well being economist at Miami College, June 6, 2025.
Cellphone interview with Maanasa Kona, affiliate analysis professor on the Heart on Well being Insurance coverage Reforms at Georgetown College, June 6, 2025.
Cellphone interview with Matthew Rae, affiliate director for the Well being Care Market Program at KFF, June 10, 2025.
Cellphone interview with Sally Pipes, president and CEO of the Pacific Analysis Institute, June 11, 2025.
E mail correspondence with Ryan Wrasse, communications director for Sen. John Thune, June 10, 2025.
KFF Well being Information, ”Some Employers Check Association To Give Employees Allowance for Protection,” Oct. 2, 2024.
KFF Well being Information, ”Trump’s ‘One Large Stunning Invoice’ Continues Assault on Obamacare,” June 3, 2025.
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