A recent national report by the Employee Benefit Research Institute (EBRI) shows that while employment-based health insurance remains the most common coverage for working-age Americans, fewer small employers are providing these benefits than in 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,” examines long-term patterns in employer-sponsored health benefits and worker eligibility.
“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.”
Key findings from the report indicate that from 1996 to 2024, there has been fluctuation in the percentage of U.S. employers offering health benefits. In 2023 this figure was near a record low at 46.3%, but it rose slightly to 49% in 2024. Most declines have occurred among small employers; large employer sponsorship has stayed stable.
Despite fewer small businesses offering plans, worker eligibility for health benefits has remained relatively constant since 1996—ranging between 75% and 81%. In 2024, about 80.2% of private-sector workers were eligible for such benefits. This stability is due largely to large employers employing roughly two-thirds of all workers.
Trends also show a decrease in overall employment-based coverage for the non-elderly population—from nearly 70% between 1970 and 1989 to about 61% in 2024—but it remains the leading source of coverage among those under age sixty-five.
Other labor market changes include an increase in full-time employment from 63% in 2014 to 69% in 2024. The share of firms with mainly low-wage workforces rose from 15% in 2023 to 21% in 2024. Additionally, the proportion of workers employed by large firms grew slightly over the past decade.
The New Jersey Business and Industry Association (NJBIA), established in February 1910 as the New Jersey Manufacturers Association and now known as one of the largest statewide employer organizations nationally according to its official website, represents private-sector employers across New Jersey’s manufacturing, retail, wholesale, contracting and service sectors. The association supports its members with advocacy efforts and resources aimed at enhancing business prosperity and maintains its headquarters at 10 West Lafayette Street in Trenton. Michele Siekerka serves as president and chief executive officer (source). NJBIA works closely with government entities and educational institutions to facilitate collaboration throughout New Jersey’s business community (more information).
