Iowa Job Quality and Family Prosperity
Iowa Job-Based Health Coverage Declines Faster than U.S. Rate
New report from Economic Policy Institute details trends


Full report from EPI (25-page PDF)

IOWA CITY, Iowa (December 6, 2012) — Although most Americans under 65 rely on health insurance offered through the workplace, the rate of coverage continues to decline, and faster in Iowa than nationally.

Those losses are documented in a new report from the Economic Policy Institute (EPI), which finds that — in just over a decade — the share of the under-65 population with job-based health care has fallen from over 69 percent in 2000 to 58.3 percent today.

“The rate of job-based health care is a little higher in Iowa, but is also declining more quickly,” said Colin Gordon, senior research consultant for the nonpartisan Iowa Policy Project (IPP). “Our rate of coverage has fallen from 76.9 percent to 66.1 percent since 2000 — a net loss of over 150,000 insured workers and family members. Over 100,000 of those losing coverage in Iowa since 2000 are under the age of 18 — a burden that is partially shouldered by increased enrollment in the state’s child health insurance program (hawk-i).”

The report by Elise Gould of EPI — available at — finds that if the rate nationally for job-based coverage remained the same in 2011 as it had been in 2000, as many as 29 million more people under age 65 would have employer-sponsored coverage.

Gordon, author of IPP's forthcoming State of Working Iowa 2012, said that upcoming report will document that pattern of declining coverage, which “reflects the intersection of three troubling trends.”

Those trends, he said, are a slipping rate at which employers offer health insurance to their employees; a declining rate also in worker participation in employers' health plans as out-of-pocket costs of coverage (and especially family coverage) continue to climb; and third, job growth over the last decade and especially since the recession being skewed heavily toward low-wage occupations that do not offer coverage.

“In a nutshell: We are losing jobs in sectors that historically offered health coverage, while the increased costs of private coverage has pushed some employers to pare back their coverage and some employees to forgo coverage even when it is offered,” Gordon said. “The result is an increased burden for public health programs like hawk-i and Medicaid, and a growing share of working Iowans with no security in the face of illness or injury.”

The Iowa Policy Project is a nonprofit, nonpartisan public policy research organization based in Iowa City. Reports are available to the public at

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