For Midlife Adults, Employer-Sponsored Health Insurance Is Main Source of Coverage

Employer-sponsored insurance (ESI), health insurance coverage offered by employers to employees and their dependents, is the principal source of coverage for adults under the age of 65.  This Fact Sheet, which updates a previous AARP Public Policy Institute report, provides a profile of adults ages 50 to 64, “midlife adults,” with ESI and suggests trends to monitor in the future.

Key Takeaways

• Nearly two-thirds of midlife adults ages 50 to 64 have ESI, whether enrolled directly with their employer or as a dependent on another person’s plan.
• ESI covers a broad range of workers ages 50 to 64, including full-time, part-time, and self-employed workers. However, not all workers in this age group have employer-sponsored insurance—some may not be offered ESI coverage, while others may not qualify for it or elect not to enroll.
• Since the implementation of the Affordable Care Act (ACA), ESI coverage among workers ages 50 to 64 has remained steady, whereas other coverage types (e.g., private Marketplace and Medicaid) have increased and uninsured rates have fallen. 

Even as parts of the health insurance landscape have evolved over the past decade, the high level of ESI coverage among adults in this age group has remained consistent; however, high and rising health care costs pose a threat to this important source of coverage. It will be important to continue to monitor ESI coverage among midlife adults, and to closely examine developments in coverage offered by employers and changes in employees’ affordability of ESI.