Figure 1. Majority of U.S. Workers Get Health Insurance Through Employers, 2007

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1 Figure 1. Majority of U.S. Workers Get Health Insurance Through Employers, 27 Other coverage* 9% Uninsured 14% Public programs 5% Own employer coverage 56% Other employer coverage 16% Million Full- and Part-Time Workers Ages *Includes those with individual insurance and other responses.

2 Figure 2. Employer-Sponsored Insurance Coverage Declined Among Small-Firm Employees, Percent of working adults^ ages Employer insurance - other Employer insurance - own Small Firms (fewer than employees) Large Firms ( or more employees) Note: Subgroups may not sum to totals because of rounding. Source: The Commonwealth Fund Biennial Health Insurance Surveys (23 and 27).

3 Figure 3. Low-Wage Employees in Small Firms Are Less Likely to Have Employer-Sponsored Insurance Coverage Percent of working adults^ ages Employer insurance - other Employer insurance - own Total <$15/hr $2/hr or more Small Firms (fewer than employees) Total <$15/hr $2/hr or more Large Firms ( or more employees) Note: Subgroups may not sum to totals because of rounding.

4 Figure 4. Over Half of Working Adults in Small Firms Were Uninsured or Underinsured During the Year, 27 Adequately insured 48% Uninsured anytime 36% Uninsured anytime 15% Underinsured 13% Underinsured 16% Adequately insured 73% Small Firms (fewer than employees) 39. million Large Firms ( or more employees) 76.9 million Underinsured is defined as having continuous health insurance coverage and spending 1 percent or more of income on out-of-pocket health care costs (or 5 percent or more if low income), or having deductibles of 5 percent or more of income.

5 Figure 5. More Than Half of Uninsured Workers Are Ineligible for Their Firm s Plan or Employed by Firms That Do Not Offer Health Benefits Worker does not know if offered or eligible 28% Employer does not offer coverage 37% Employer offers, worker eligible, does not participate 2% Employer offers, worker ineligible 16% 17.3 Million Uninsured Workers Ages 19 64

6 Figure 6. Workers in Small Firms Are Less Likely to Be Offered and Eligible for Health Insurance from Their Employer Percent of working adults^ ages Employer offers a plan Eligible for employer plan Total <$15/hr $2/hr or more Total <$15/hr $2/hr or more Small Firms (fewer than employees) Large Firms ( or more employees)

7 Figure 7. Share of Small Firms Offering Benefits to Employees and Employee Eligibility Declined, Percent of working adults^ ages Employer offers a plan Eligible for employer plan Small Firms (fewer than employees) Large Firms ( or more employees) Source: The Commonwealth Fund Biennial Health Insurance Surveys (23 and 27).

8 Figure 8. When Employees in Small Firms Are Offered and Eligible for Employer-Sponsored Coverage, Take-Up Rate Is High Percent of working adults^ ages who are eligible for and take up employer-sponsored insurance <2 employees 2 99 employees employees + employees

9 Figure 9. Low-Wage Workers in Small Firms Are Less Likely to Have Health Insurance Than High-Wage Workers in Small Firms Insurance sources for working adults^ ages Employer - own Employer - other Individual Public Other All workers Total <$15/hr $2/hr or more Total <$15/hr $2/hr or more 2 1 Small Firms (fewer than employees) Large Firms ( or more employees)

10 Figure 1. The Individual Insurance Market Is Not an Affordable Option for Small-Firm Workers^ Working adults ages 19 64: Has individual coverage or tried to buy it in past three years Among those: Found it very difficult or impossible to find coverage they needed Found it very difficult or impossible to find affordable coverage Were turned down, charged a higher price, or had a specific health problem excluded from coverage Total < employees + employees <$15/hr $2/hr+ % 38% 18% % % 39% Any of the above Never bought a plan* 67 44% *Among those who tried to buy a plan. 34% % 63 34%

11 Figure 11. Share of Workers Spending Large Shares of Income on Out-of-Pocket Medical Expenses Increased, Percent of working adults^ ages with own employer-sponsored insurance 1 5% or more of income 1% or more of income Total Small Firms (fewer than employees) Large Firms ( or more employees) Source: The Commonwealth Fund Biennial Health Insurance Surveys (23 and 27).

12 Figure 12. Workers with Lower Wages, Regardless of Employer Size, Are More Likely to Spend Large Share of Income on Out-of-Pocket Medical Costs and Premiums Percent of working adults^ ages with own employer-sponsored insurance 1 5%or more of income 1%or more of income Small Firms (< employees) Large Firms (+ employees) <$15/hr $2/hr or more Large Firms ( or more employees)

13 Figure 13. Insurance Benefits Are Not as Generous for Workers in Small Businesses Percent of working adults^ ages with own employer-sponsored insurance < employees + employees Coverage limits total amount it will pay for medical care No prescription drug coverage Fair or poor rating of insurance plan

14 Figure 14. Cost of Administering Health Insurance as a Percentage of Claims Under Current Law and the Proposed Exchange, by Group Size Percent Current Exchange Total Individuals 2 to 4 5 to 9 1 to 19 2 to 49 to 99 1 to 499 to 2,499 2, to 9,999 1, + Data: Estimates by The Lewin Group for The Commonwealth Fund. Source: Commonwealth Fund Commission on a High Performance Health System, The Path to a High Performance U.S. Health System: A 22 Vision and the Policies to Pave the Way (New York: The Commonwealth Fund, Feb. 29).