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<classification authority="sudocs">GA 1.13:HEHS-97-35</classification>
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 <subject>Health insurance</subject>
 <subject>Employee medical benefits</subject>
 <subject>Dependents</subject>
 <subject>Health insurance cost control</subject>
 <subject>Health care programs</subject>
 <subject>Insurance premiums</subject>
 <subject>Inflation</subject>
 <subject>Employee benefit plans</subject>
 <subject>Managed health care</subject>
 <identifier>Medicaid Program</identifier>
 <identifier>Census Bureau Current Population Survey</identifier>
 <identifier>Aid to Families with Dependent Children Program</identifier>
 <identifier>AFDC</identifier>
 <identifier>Supplemental Security Income Program</identifier>
 <identifier>HHS Temporary Assistance for Needy Families Program</identifier>
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<titleInfo>
 <title>Employment-Based Health Insurance: Costs Increase and Family Coverage Decreases</title>
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<abstract>Pursuant to a congressional request, GAO provided information on the
decline in employment-based health insurance, focusing on: (1) recent
trends in employment-based private health insurance, particularly for
family coverage; (2) any corresponding changes in the number of adults
and children with private insurance coverage as dependents; and (3) the
potential effect of these changes, if any, on public costs for health
care coverage.&lt;p/&gt;GAO found that: (1) eroding employer financial support for providing
health insurance to employees&apos; families has contributed to the overall
decline in private health insurance coverage; (2) each year between the
late 1980s and 1994, increases in employers&apos; costs to provide health
insurance to their employees and their employees&apos; families outpaced
inflation, with cost growth of 18 percent one year; (3) as health
insurance reached 10 percent of employees&apos; payroll costs, many employers
began to reconsider the amount of support they would provide to
employees, particularly for family coverage; (4) acquiring or
maintaining health insurance has become more difficult for some families
because of changes that some employers made to their firms&apos; health
coverage; (5) some employers, particularly smaller employers, dropped
coverage altogether; (6) in 1993, over 29 million employees, almost
one-fourth of the workforce, were employed by firms that did not offer
group health insurance for employees&apos; families; (7) most employers
continued to offer coverage, but many raised employees&apos; premium
contributions significantly, especially for family coverage; (8) in
1993, 16 percent of employees in large private firms paid $150 or more
per month for family health insurance premiums and 36 percent of state
and local government employees paid as much in 1992; (9) some employers
have used other mechanisms that could discourage employees from
two-worker families from purchasing family coverage from them; (10) as
these changes occurred, the percentage of Americans under 65 years old
with private health insurance coverage decreased from 75 percent in 1989
to about 71 percent in 1995; (11) of this general decline, about 70 to
90 percent was due to fewer working-age adults and children being
covered as dependents; (12) between 1989 and 1995, the percentage of
working-age adults, 18 to 64 year olds, with private insurance coverage
decreased from 76 percent to 73 percent; (13) over these 6 years, the
percentage of children under 18 years old with private health insurance
decreased from more than 73 percent to 66 percent; (14) declines in
employment-based dependent coverage can increase the number of uninsured
Americans and shift a greater burden for health care onto public payers;
(15) between 1994 and 1996, health insurance premium costs have been
relatively stable, which may help slow the erosion of private coverage;*</abstract>
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<identifier type="preferred citation">GAO/HEHS-97-35</identifier>
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<note>Letter Report</note>
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 <searchTitle>GAO/HEHS-97-35; Employment-Based Health Insurance: Costs Increase and Family Coverage Decreases;
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<subject>
 <topic>Health insurance</topic>
 <topic>Employee medical benefits</topic>
 <topic>Dependents</topic>
 <topic>Health insurance cost control</topic>
 <topic>Health care programs</topic>
 <topic>Insurance premiums</topic>
 <topic>Inflation</topic>
 <topic>Employee benefit plans</topic>
 <topic>Managed health care</topic>
 <topic>Medicaid Program</topic>
 <topic>Census Bureau Current Population Survey</topic>
 <topic>Aid to Families with Dependent Children Program</topic>
 <topic>AFDC</topic>
 <topic>Supplemental Security Income Program</topic>
 <topic>HHS Temporary Assistance for Needy Families Program</topic>
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