Employer-sponsored insurance (ESI) remains the backbone of health coverage for working Americans, with more than 165 million workers participating in workplace plans as of March 2025. Of the 6 in 10 non-elderly people with ESI, 85.7 million (52%) had ESI from their own job; 73.6 million (44%) were covered as a dependent by someone within their household; and 6.3 million (4%) were covered as a dependent by someone living outside of their household.
However, a wide range of factors makes access highly variable.
"People's access to ESI depends on the availability and cost of coverage where they or a family member work," according to a new report from the Peterson-KFF Health System Tracker. "A large share of workers are eligible for coverage offered at their job, but this again is uneven. Workers with low incomes as well as workers who are younger, identify as women, work part-time or are non-citizens are each less likely to be eligible for ESI at their jobs compared to their counterparts."
There also are significant differences across racial and ethnic groups. Hispanic people and non-Hispanic American Indian/Alaskan Native people have much lower rates of eligibility for ESI. Additionally, some workers eligible for ESI at work choose not to take it because they consider it too expensive.
About 4 in 5 adult non-elderly employees work for an employer that offered ESI to at least some workers, a share that has been consistent over recent years. Because 93% of these workers are eligible for the ESI offered at their job, about three in four workers are eligible to enroll in ESI offered at their workplace. The share of workers eligible for ESI at their job declined slightly over the past few years, from 75.3% in March 2023 to 74.6% in March 2025.
Access can be correlated to several key variables:
- Income. More than 4 in 5 adults younger than 65 with incomes of 400% or more of the federal poverty level have ESI, compared to 57% with incomes between 200% and 399% of the poverty level and 22.5% with incomes below 200%.
- Age. Younger workers are less likely than those in older age groups to have ESI.
- Race and ethnicity. Compared to Non-Hispanic white people, Hispanics are almost half as likely to have ESI. Non-Hispanic people who are Black; American Indian or Alaskan Native, Native Hawaiian or other Pacific Islander; or of mixed race also are less likely to ESI.
- Occupation. Employees working in construction; service; sales; and farm, fishing and forestry-related occupations are less likely to be working for an employer offering ESI and to be eligible for ESI at their jobs.
- Job category. Full-time workers are much more likely to be working for an employer offering ESI and to be eligible for coverage at their job than part-time workers.
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