As employers and workers struggle to absorb the skyrocketing cost of health insurance, fewer Texans below age 65 are opting for coverage through their jobs.
In 2008-2009, 51.5 percent of the state’s nonelderly population enrolled in a plan through an employer, down from 62 percent in 1999-2000, according to a June study from the Robert Wood Johnson Foundation and the State Health Access Data Assistance Center.
Nationally, the share decreased by 8 percentage points to 61.4 percent in 2008-2009.
As fewer people receive employer-sponsored insurance, more have shifted to public coverage. The percentage of Texans receiving coverage through programs such as Medicare and Medicaid rose from 10.2 percent to 17.2 percent.
That still leaves 27.4 percent of nonelderly Texas workers uninsured — the highest rate in the country.
The study also found that while the share of private-sector employees of all ages eligible to receive benefits through work remained steady, fewer enrolled. In Texas, the share dropped from 83.4 percent in 1999-2000 to 78.1 percent in 2008-2009.
Joshua Sutin, an employee benefits attorney at Cox Smith, said rising premiums and the larger contributions workers have to pay along with them likely were causes for the declines.
“The cost of insurance has gone up to the point where it’s pushed people out of the market,” he said.
In Texas, the average price of an annual premium grew from $2,482 to $4,352. The average employee contribution jumped 114 percent, from $428 to $918.
The study also found fewer dependents in Texas are being covered by insurance through a family member’s employer. Despite the number of policyholders increasing by a 118,000 during the past decade, 177,000 fewer dependents were enrolled.
The report also cites high costs as a likely factor driving this trend. In Texas, the price of an annual family plan grew from $6,424 in 2008-2009 to $10,945 in 2008-2009. The average employee contribution for a family plan rose from $1,780 to $3,389.
Additionally, the report found that low-income earners in the state were the most likely to lose coverage. On top of that, a greater share of the nonelderly population now is in the low-income category: The percentage of the population earning less than 200 percent of the federal poverty line grew from 41.1 percent to 45.7 percent.
But as the share of workers earning less has grown, the share of firms offering coverage has dropped. The percentage of Texas companies providing benefits declined from 52.7 percent to 49.8 percent. Employers with fewer than 50 employees were the most likely to drop coverage.
According to the Urban Institute, a nonpartisan research group, the introduction of health insurance exchanges and tax credits for smaller, low-wage employers in 2014 through the Affordable Care Act is expected to help reverse some of the negative trends identified by the Robert Wood Johnson study. In particular, smaller firms are expected to “experience substantial savings” on costs and be able to offer more coverage to employees.
Until then, Sutin said it was likely that more Texans will turn down employer-sponsored insurance and more small firms will stop offering coverage.
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