Health Insurance Coverage Among US Workers; Differences by Work Arrangements

March 26, 2019
NIOSH Update:

Contact: Nura Sadeghpour (202) 245-0673

Group of US Workers

The National Institute for Occupational Safety and Health (NIOSH) recently published a studyexternal icon that compared the rates of health insurance coverage among workers in different work arrangements between 2010 and 2015. While rates of health insurance coverage among workers in all categories went up significantly during this time period, substantial disparities in health insurance coverage persisted for workers with non-standard work arrangements.

For most Americans, health insurance is obtained through employers. This option can vary depending on whether a worker is employed with a standard, permanent and full-time employment, or through non-standard arrangements. Non-standard work is defined as those types of work arrangements that deviate in some way from the standard and are commonly known as part-time, temporary, consultant, freelance, or contractor workers.

“Other studies have shown that non-standard work arrangements have been linked to higher risks of work-related injury and illness,” said Sara Luckhaupt, MD, one of the lead authors of the study. “NIOSH is interested in how the lack of health insurance benefits might contribute to these higher risks. The first step was to compare rates of health insurance coverage across the types of different work arrangements.”

For workers age 18-64 during the study period, researchers found:

  • In 2010, workers in nonstandard work arrangements had significantly lower rates of health insurance coverage than workers in standard work arrangements.
  • In 2015, the differences in rates of health insurance coverage were less pronounced, but workers in nonstandard work arrangements were still less likely to have health insurance compared to workers in standard work arrangements.
  • Workers in full-time, standard work arrangements in medium and large establishments were more likely to have health insurance than either workers in small establishments in standard, full-time work arrangements or part-time workers.

Health insurance coverage could be extremely important for part-time, temporary, consultant, freelance, or contractor workers in particular. These non-standard work arrangements have been linked to higher risks of work-related injury and illness. Many workers in these arrangements are less experienced and receive less safety training while engaging in more hazardous activities than workers in standard employment arrangements. Study authors say that further research is needed to monitor health insurance coverage trends among these workers, since risks may be magnified by a lack of health insurance and other benefits.

The study, Health Insurance Coverage Among U.S. Workers: Differences by Work Arrangements in 2010 and 2015, was published this monthexternal icon in the American Journal of Preventive Medicine.

NIOSH is the federal institute that conducts research and makes recommendations for preventing work-related injuries and illnesses. More information about NIOSH can be found at www.cdc.gov/niosh.

Page last reviewed: March 26, 2019