A new national report from the Employee Benefit Research Institute (EBRI) shows that while employment-based health insurance remains the most common form of coverage for working-age Americans, fewer small employers are providing these benefits compared to previous years.
The EBRI report, titled “The Shifting Landscape of Employment-Based Health Benefits: Long-Term Resilience, Small-Employer Erosion, and the Threat of Higher Premiums,” reviews trends in employer-sponsored health benefits and employee eligibility over time.
“If health insurance premiums rise faster than wages and general inflation, small employers are likely to face intensified financial strain, which could accelerate the erosion of health plan sponsorship among firms with fewer than 100 workers,” said Paul Fronstin, Director of Health Benefits Research at EBRI.
“Large employers, while more resilient, may respond by shifting costs to employees through higher deductibles, coinsurance, or restricted networks. That could preserve offer rates but reduce the value of coverage, potentially lowering take-up. For workers, the impact could be significant, meaning higher out-of-pocket costs, greater reliance on public programs and increased financial insecurity tied to health care expenses.”
The report notes that between 1996 and 2024, the percentage of U.S. employers offering health benefits has fluctuated. After reaching a low point of 46.3% in 2023, this figure rose slightly to 49%. Most declines occurred among small businesses; large employer sponsorship remained steady.
Despite reductions among small businesses, worker eligibility for health benefits has been stable since 1996—ranging from 75% to 81%. In 2024, about 80.2% of private-sector workers were eligible for such benefits. This consistency is attributed to large employers who employ about two-thirds of all workers.
The proportion of non-elderly people with employment-based health coverage dropped from near 70% during the period from 1970 to 1989 to about 61% in 2024. Nonetheless, it remains the leading source of coverage for this group.
Labor market data show that full-time employment increased from 63% in 2014 to 69% in 2024. The share of companies with mainly low-wage workforces rose from 15% in 2023 to 21% in 2024. Meanwhile, workers employed by large firms also grew slightly—from 65% in 2013 to 67% in 2024.
Organizations such as the New Jersey Business and Industry Association (NJBIA), established in February 1910 and based in Trenton at 10 West Lafayette Street, represent a wide range of employers across sectors like manufacturing and services. The NJBIA serves as a resource for private-sector employers throughout New Jersey by providing advocacy and practical information aimed at supporting business prosperity (source). Led by President and CEO Michele Siekerka (source), NJBIA also works to build partnerships between businesses, government entities, and educational institutions (source).