Medical Expenditure and Health Insurance in the United States



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Medical Expenditure Panel Survey STATISTICAL BRIEF #178 Agency for Healthcare Research and Quality July 27 Highlights Offer Rates, Take-Up Rates, Premiums, and Employee Contributions for Employer-Sponsored Health Insurance in the Private Sector for the 1 Largest Metropolitan Areas, 25 John P. Sommers, PhD Introduction Employer-sponsored health insurance for current workers is one of the primary sources of health insurance coverage in the United States. According to data from the Insurance Component of the 25 Medical Expenditure Panel Survey (MEPS-IC), approximately 97.5 million of the 112.2 million employees from the private sector worked in firms where the employer offered health insurance. Of those employees who worked where health insurance was offered, approximately 61.1 million were enrolled. In recent years, premiums and employee contributions for employer-sponsored health insurance have risen significantly, while offer and enrollment rates have dropped modestly. These values for employer-sponsored health insurance vary considerably by where one lives and other factors, such as size of firm and industry. This Statistical Brief presents average offer and take-up rates, single and family premiums, and single and family employee contributions for private sector employers in the 1 largest metropolitan areas and compares these values to national averages for the private sector. Only those estimates with a statistically significant difference from the national average at the.5 percent significance level are noted in the text. Findings Among the 112.2 million private sector employees in the United States, 86.9 percent worked where employer-sponsored health insurance was offered in 25 (figure 1). Among the 1 largest metropolitan areas, had a rate higher than the national average, 93.6 percent. In 25, 86.9 percent of private sector employees worked where health insurance was offered. This value varied across the 1 largest metropolitan areas, and in one of the 1 areas, the rate was higher than the national average. In 25, 62.5 percent of private employees who worked where health insurance was offered enrolled. Of the 1 largest metropolitan areas, only one had a higher than average rate of enrollment among those who worked where insurance was offered. The average premium for single coverage among private sector employers who offered health insurance was $3,991. Among the 1 largest metropolitan areas, the average ranged from $3,725 to $4,513. The average private sector employee contribution for single coverage was $723. The average premium for family coverage in 25 among private sector employers who offered health insurance was $1,728. Among the 1 largest metropolitan areas, two had averages higher than the national average. The average private sector employee contribution for single coverage was $2,585. This value varied significantly among the 1 largest metropolitan areas. Among private sector employees who worked where health insurance was offered, 62.5 percent enrolled (figure 2). The enrollment rates for nine of the 1 largest metropolitan areas did not differ significantly from the national average. Only Washington, D.C., which had a higher enrollment rate of 69.7 percent, differed from the national average.

In 25, the average single premium in the private sector for employer-sponsored health insurance was $3,991 (figure 3). The value for City $4,513 was significantly higher than the national average. In 25, among private sector employers, the average employee contribution for single coverage was $723 (figure 4). Among private sector employers, the average premium for family coverage in 25 was $1,728 (figure 5). Two of the 1 largest metropolitan areas City and had higher averages, at $11,819 and $11,294, respectively. was lower than the national average with an average premium of $1,122. In 25, the average private sector employee contributed $2,585 towards family coverage for employersponsored health insurance (figure 6). Among the 1 largest metropolitan areas, the value for, $3,559, was higher than the national average. Data Source This Statistical Brief summarizes data from the 25 MEPS-IC. The data are available on the MEPS Web site at http://www.meps.ahrq.gov/mepsweb/data_stats/quick_tables.jsp or have been produced using special computation runs on the confidential MEPS-IC data available at the U.S. Census Bureau. Definitions Employer In this Statistical Brief, an employer is defined as a private sector firm. A firm is defined as a business entity that controls one or more business establishments or locations. Consequently, an employer can have multiple work locations. Single coverage Single coverage is health insurance that covers the employee only. This is also known as employee-only coverage. Family coverage Family coverage is health insurance that covers the employee and one or more members of his/her immediate family (spouse and/or children as defined by the plan). For the MEPS-IC survey, family coverage is any coverage other than single and employee-plus-one. Some plans offer more than one rate for family coverage, depending on family size and composition. If more than one rate is offered, survey respondents are asked to report costs for a family of four. Metropolitan areas Metropolitan areas are Metropolitan Statistical Areas (MSAs) defined and published by the Office of Management and Budget (OMB) as of June 6, 23. Counties included in each area can be found in the Appendix of OMB Bulletin No. 4-3 (http://www.whitehouse.gov/omb/bulletins/fy4/b4-3.html). Size and ranking of metropolitan areas was determined using the most recent U.S. Census Bureau ranking (http://www.census.gov/population/www/estimates/estimates%2pages_final.html). Note that the name of the central city of each MSA has been used in the text and tables for convenience and brevity. The areas consist of more than the central cities. For instance, Washington, D.C., consists of the central city plus counties in Maryland, Virginia, and West Virginia. About MEPS-IC MEPS-IC is a survey of business establishments and governments that collects information on employersponsored health insurance, such as whether insurance is offered, enrollments, types of plans, and premiums. The survey is conducted annually by the U.S. Bureau of the Census under the sponsorship of the Agency for Healthcare Research and Quality. The yearly response rate has averaged 78 percent for in-scope sample units. Approximately 4 percent of the original sample has been out-of-scope in a typical

year. A total sample of 42, establishments was selected for the 25 survey, prior to accounting for losses due to nonresponse and out-of-scope cases. For more information on this survey, see MEPS Methodology Reports 6, 8, 1, 14, 17, and 18 on the MEPS Web site at http://www.meps.ahrq.gov/mepsweb/data_stats/publications.jsp and Insurance Component Survey Basics at http://www.meps.ahrq.gov/mepsweb/survey_comp/insurance.jsp. Suggested Citation Sommers, J. P. Offer Rates, Take-Up Rates, Premiums, and Employee Contributions for Employer- Sponsored Health Insurance in the Private Sector for the 1 Largest Metropolitan Areas, 25. Statistical Brief #178. July 27. Agency for Healthcare Research and Quality, Rockville, Md. http://www.meps. ahrq.gov/ mepsweb/data_files/publications/st178/ stat178.pdf AHRQ welcomes questions and comments from readers of this publication who are interested in obtaining more information about access, cost, use, financing, and quality of health care in the United States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. Please e-mail us at mepsprojectdirector@ahrq.hhs.gov or send a letter to the address below: Steven B. Cohen, PhD, Director Center for Financing, Access, and Cost Trends Agency for Healthcare Research and Quality 54 Gaither Road Rockville, MD 285

Figure 1. Percentage of private sector employees who worked where health insurance was offered, United States and 1 largest metropolitan areas, 25 1 85.4 87.4 85.9 87.9 93.6 86.1 86. 86.2 88.4 88. 86.9 8 Percent 6 4 2 Figure 2. Percentage of private sector employees enrolled in health insurance in establishments that offered health insurance, United States and 1 largest metropolitan areas, 25 8 6 63.4 65.8 65.2 63.5 63.9 69.8 61.5 69.7 63.7 69.1 62.5 Percent 4 2 Statistical Brief #178: Offer Rates, Take-Up Rates, Premiums, and Employee Contributions for Employer-Sponsored Health Insurance in the Private Sector for the 1 Largest Metropolitan Areas, 25

Figure 3. single premium per enrolled employee at private sector establishments offering health insurance, United States and 1 largest metropolitan areas, 25 5, 4, 4,513 3,838 4,76 4,94 4,275 3,841 4,181 4,248 3,725 4,236 3,991 3, 2, 1, Figure 4. employee contribution per enrolled employee for single coverage at private sector establishments offering health insurance, United States and 1 largest metropolitan areas, 25 1, 8 6 4 732 632 888 627 786 95 647 857 658 77 723 2 Statistical Brief #178: Offer Rates, Take-Up Rates, Premiums, and Employee Contributions for Employer-Sponsored Health Insurance in the Private Sector for the 1 Largest Metropolitan Areas, 25

Figure 5. family premium per enrolled employee at private sector establishments offering health insurance, United States and 1 largest metropolitan areas, 25 1, 11,819 1,122 1,676 11,59 11,294 1,535 11,571 11,256 1,246 1,877 1,728 7,5 5, 2,5 Figure 6. employee contribution per enrolled employee for family coverage at private sector establishments offering health insurance, United States and 1 largest metropolitan areas, 25 4, 3,5 3, 2,5 2, 2,564 2,386 2,235 2,624 2,549 3,559 3,67 3,4 2,739 1,937 2,585 1,5 1, 5 Statistical Brief #178: Offer Rates, Take-Up Rates, Premiums, and Employee Contributions for Employer-Sponsored Health Insurance in the Private Sector for the 1 Largest Metropolitan Areas, 25