“The most common source of health insurance for the noninstitutionalized civilian population under age 65 is a current or former employer—either one’s own or a family member’s. In CBO and JCT’s estimates, a monthly average of about 159 million people (or about 58 percent of the population under age 65) have employment-based coverage in 2019—a decrease from 2018, when an estimated 160 million people had employment-based coverage. The agencies estimate that the decline largely stems from the elimination of the penalty associated with the individual mandate.3 (For a discussion of the various ways in which repealing the individual mandate penalty affects health insurance coverage, see Box 1-2.)

“According to CBO’s estimates, access to an offer of employment-based insurance varies notably by income: About 36 percent of people with income below 150 percent of the FPL are estimated to have access to such coverage in 2019, while about 90 percent of people with income above 400 percent of the FPL do (see Figure 1-3 on page 12). People’s decision to take up an offer of employment-based coverage also varies notably with income. In CBO’s projections, about 21 percent of people with income below 150 percent of the FPL enroll in employment-based coverage, while about 88 percent of people with income above 400 percent of the FPL do.

“CBO and JCT estimate that the number of people enrolled in employment-based coverage over the next decade will not change significantly. By the agencies’ projections, continued growth in employment and wages tends to boost the number of people with employment-based coverage in part because more workers have access to such coverage. Also, higher wages mean workers are less likely to be eligible for subsidies in the marketplaces established under the Affordable Care Act (ACA) and thus have a greater preference for employment-based coverage. But those factors that would increase enrollment are expected to be generally offset over the decade, because health insurance premiums are projected to grow faster than wages, which tends to decrease the number of employers that offer health insurance and the number of people who enroll in it.”

Source: Congressional Budget Office, “Federal Subsidies for Health Insurance Coverage for People Under Age 65: 2019 to 2029” (May 2019), https://www.cbo.gov/publication/55085.