U.S. Department of Commerce

Economics and Statistics Administration

U.S. CENSUS BUREAU

Health Insurance Coverage of 

Workers Aged 18 to 64, by Work 

Experience: 2008 and 2010

American Community Survey Briefs

Issued September 2011

ACSBR/10-11

By

Matthew W. Brault

and

Laura F. Blumenthal

For many Americans, health insurance coverage is tied to their work. 

Specifically, a majority of U.S. residents have health insurance coverage 

through their own or a family member’s employer or union.1 Yet, people 

may lose eligibility for employerbased health insurance after they 

(or a family member) lose a job or 

shift from full-time to part-time or 

temporary work. While individuals 

can always purchase insurance in the 

open market, this option is often not 

affordable due to preexisting conditions or the absence of employer 

subsidies. Consequently, employment 

is not only associated with employerbased health insurance coverage, but 

with overall health insurance coverage as well.

To help alleviate this dependency, 

Congress passed laws to increase the 

portability and affordability of private 

coverage options. COBRA allows 

individuals to purchase the same coverage they received while working, 

albeit for a limited period of time 

and without the employer subsidy.2

More recently, the Affordable Care 

Act has mandated that states create 

health exchanges by 2014, through 

which people who lose full-time 

employment would be able to 

1 About 167.1 million people, or 54.9 percent 

of the civilian noninstitutionalized population, had 

employer-based health insurance coverage in 2010 

(Table B27004, available at <http://factfinder2

.census.gov>). 2 Consolidated Omnibus Budget Reconciliation 

Act of 1985, P.L. 99–272, 100 Stat. 82.

DEFINITIONS

Work experience: A summary of whether 

a person worked, the number of weeks 

worked, and the usual number of hours 

worked per week in the past 12 months.

Workers: People who worked in the past 

12 months.

Full-time, year-round worker: Workers 

who usually worked 35 hours or more per 

week for 50 to 52 weeks in the past 12 

months.

Less than full-time, year-round worker: 

Workers who usually worked fewer than 

35 hours per week and/or fewer than 50 

weeks in the past 12 months. This includes 

part-time workers, temporary or seasonal 

workers, and people who may have lost a 

job in the past 12 months.

Nonworkers: People who have not worked 

in the past 12 months.

Employer-based health insurance: 

Health insurance provided through a 

worker’s own (or family member’s) current, 

or former, employer or union.

Non-employer-based health insurance: 

Any other health insurance type, private 

or public. This includes: direct-purchase 

health insurance (purchased directly from 

an insurance company by an individual or 

an individual’s relative), Medicaid or other 

means-tested public coverage, Medicare, 

TRICARE or other military health 

coverage, or VA Health Care.

Uninsured: Has no health insurance coverage (through an employer or otherwise).
2 U.S. Census Bureau

individually purchase an affordable 

health insurance plan.3

Using data from the 2008 and 2010 

American Community Surveys 

(ACS), this report explores work 

experience and health insurance 

coverage statuses of people aged 

18 to 64 in the United States during 

the years surrounding the trough 

3 Department of Health and Human 

Services: Initial Guidance to States on 

Exchanges <www.hhs.gov/ociio/regulations

/guidance_to_states_on_exchanges.html>.

of the recent recession.4 The data 

presented are for the civilian noninstitutionalized population. This 

universe excludes people living in 

prisons and nursing facilities and 

those in the armed forces.

4 Because the ACS collects information 

throughout the year, questions with 12-month 

retrospectives, like earnings and work experience, yield 1-year ACS estimates with time 

spans of 23 months. For example, respondents surveyed in January 2008 report their 

work experience for January 2007 through 

December 2007, while respondents surveyed 

in December 2008 report their work experience for December 2007 to November 2008. 

The comparisons made between 2008 and 

2010 ACS estimates do not have overlapping 

reference periods. For more information, 

see Hogan, Howard, “Measuring Population 

Change Using the American Community 

Survey,” Applied Demography in the 21st 

Century, eds., Steven H. Murdock and David 

A. Swanson, Springer Netherlands, 2008.

EMPLOYER-BASED HEALTH 

INSURANCE COVERAGE OF 

WORKERS IN THE UNITED 

STATES

From 2008 to 2010, the number of 

workers aged 18 to 64 decreased 

from 152.4 million (81.2 percent 

of all 18-to-64 year olds) to 147.5 

million (77.2 percent), a proportional drop of 4.1 percentage 

points (Tables 1 and 2). This net 

decrease of 4.9 million fewer workers resulted from 7.5 million fewer 

full-time, year-round workers and 

2.6 million more workers reporting 

having worked less than full time, 

year round.

During this period, among workers both the number and percentage with employer-based health 

insurance decreased. About 67.1 

Table 1. 

Health Insurance Coverage by Work Experience: 2008 and 2010

(Workers aged 18 to 64 in the civilian noninstitutionalized population. Numbers in thousands)

Characteristic

2008 2010 Difference

Number

Margin of 

error (±)1 Percent

Margin of 

error (±)1 Number

Margin of 

error (±)1 Percent

Margin of 

error (±)1 Number Percent

 All workers . . . . . . . . . . . . . . . . 152,355 122 100.0 (X) 147,483 135 100.0 (X) *–4,871 (X)

With employer-based health insurance . . 105,477 187 69.2 0.1 99,018 194 67.1 0.1 *–6,458 *–2.1

With non-employer-based health 

insurance . . . . . . . . . . . . . . . . . . . . . . . 18,808 76 12.3 0.1 19,219 87 13.0 0.1 *411 *0.7

Uninsured . . . . . . . . . . . . . . . . . . . . . . . . 28,070 149 18.4 0.1 29,246 139 19.8 0.1 *1,176 *1.4

 Full-time, year-round 

 workers . . . . . . . . . . . . . . . . . 99,989 112 100.0 (X) 92,518 118 100.0 (X) *–7,472 (X)

With employer-based health insurance . . 77,803 142 77.8 0.1 71,772 143 77.6 0.1 *–6,031 *–0.2

With non-employer-based health 

insurance . . . . . . . . . . . . . . . . . . . . . . . 8,214 47 8.2 0.1 7,877 53 8.5 0.1 *–337 *0.3

Uninsured . . . . . . . . . . . . . . . . . . . . . . . . 13,973 99 14.0 0.1 12,869 89 13.9 0.1 *–1,104 –0.1

 Less than full-time, year-

 round workers . . . . . . . . . . . . 52,365 115 100.0 (X) 54,966 122 100.0 (X) 2,600 (X)

With employer-based health insurance . . 27,674 89 52.8 0.1 27,247 107 49.6 0.1 *–427 *–3.3

With non-employer-based health 

insurance . . . . . . . . . . . . . . . . . . . . . . . 10,594 58 20.2 0.1 11,342 58 20.6 0.1 *747 *0.4

Uninsured . . . . . . . . . . . . . . . . . . . . . . . . 14,097 80 26.9 0.1 16,377 82 29.8 0.1 *2,280 *2.9

* Statistically different from zero at the 90 percent confidence level.

(X) Not applicable.

1

 A margin of error is a measure of an estimate’s variability. The larger the margin of error in relation to the size of the estimate, the less reliable the estimate. 

For further information on the accuracy of the estimates, including standard errors and margins of error, please see the ACS and PRCS “Accuracy of the Data” for 

2008 and 2010 at <www.census.gov/acs/www/data_documentation/documentation_main/>.

Sources: U.S. Census Bureau, 2008 and 2010 American Community Surveys.
U.S. Census Bureau 3

Figure 1. 

Employer-Based Health Insurance Coverage Rate for All Workers by

Work Experience and State: 2010

Source: U.S. Census Bureau, 2010 American Community Survey.

0 20 40 60 80 100

Puerto Rico

New Mexico

Florida

Texas

Montana

Arizona

Louisiana

Alaska

California

Idaho

Arkansas

Oklahoma

Mississippi

North Carolina

Colorado

Georgia

Nevada

Oregon

South Carolina

South Dakota

Tennessee

Vermont

United States

Wyoming

Maine

Kentucky

Washington

Alabama

Utah

Nebraska

New York

Illinois

Michigan

Missouri

West Virginia

Indiana

Kansas

Virginia

North Dakota

Rhode Island

Ohio

Delaware

Iowa

Minnesota

Wisconsin

District of Columbia

Maryland

New Jersey

Connecticut

Pennsylvania

Hawaii

New Hampshire

Massachusetts

Full-time, year-round workers Less than full-time, year-round workers All workers 

Percent
4 U.S. Census Bureau

Table 2. 

Change in the Percentage of the Population Who Worked in the Past 12 Months, Work 

Experience and Health Insurance Coverage of Workers for the United States, States, and 

Puerto Rico: 2008 to 2010

(Civilian noninstitutionalized population 18 to 64 years)

Area

Change in percentage who 

worked in the past 12 months

Workers

Change in percentage who 

worked full time, year round

Change in percentage with 

employer-based health 

insurance

Change in percentage who 

were uninsured

Estimate

Margin of 

error (±)1 Estimate

Margin of 

error (±)1 Estimate

Margin of 

error (±)1 Estimate

Margin of 

error (±)1

 United States . . . . . *–4.1 0.1 *–2.9 0.1 *–2.1 0.1 *1.4 0.1

Alabama . . . . . . . . . . . . . . . . *–4.6 0.7 *–3.7 0.7 *–2.4 0.8 *1.5 0.7

Alaska . . . . . . . . . . . . . . . . . . *–2.9 1.2 0.9 1.8 –0.8 2.4 0.9 2.0

Arizona . . . . . . . . . . . . . . . . . *–5.2 0.7 *–4.4 0.8 *–0.9 0.9 –0.8 0.8

Arkansas . . . . . . . . . . . . . . . . *–3.0 0.8 *–1.9 1.1 0.2 1.2 0.8 1.1

California . . . . . . . . . . . . . . . . *–4.6 0.2 *–3.3 0.3 *–2.0 0.4 *1.7 0.3

Colorado . . . . . . . . . . . . . . . . *–3.3 0.5 *–3.9 0.7 *–1.8 0.9 –0.1 0.8

Connecticut . . . . . . . . . . . . . . *–2.7 0.7 *–2.7 0.8 *–3.1 0.9 0.5 0.7

Delaware . . . . . . . . . . . . . . . . *–5.2 1.4 *–2.7 1.5 –1.3 1.6 –0.3 1.3

District of Columbia . . . . . . . . *–5.2 1.9 –0.4 2.1 1.5 1.9 0.3 1.3

Florida . . . . . . . . . . . . . . . . . . *–5.9 0.3 *–3.6 0.5 *–3.2 0.5 *2.0 0.5

Georgia . . . . . . . . . . . . . . . . . *–5.8 0.5 *–3.2 0.5 *–1.6 0.6 *1.9 0.6

Hawaii . . . . . . . . . . . . . . . . . . *–3.8 1.0 *–2.2 1.4 *–3.4 1.5 *1.2 0.9

Idaho . . . . . . . . . . . . . . . . . . . *–3.8 0.8 *–5.5 1.4 *–2.1 1.3 *2.0 1.2

Illinois . . . . . . . . . . . . . . . . . . . *–3.9 0.3 *–3.2 0.4 *–2.4 0.5 *1.8 0.4

Indiana . . . . . . . . . . . . . . . . . . *–4.9 0.4 *–3.2 0.6 *–2.5 0.7 *1.9 0.6

Iowa . . . . . . . . . . . . . . . . . . . . *–2.4 0.5 *–2.3 0.7 *–1.7 0.8 *1.1 0.6

Kansas . . . . . . . . . . . . . . . . . . *–3.9 0.6 *–3.3 0.9 *–3.2 0.9 *2.9 0.8

Kentucky . . . . . . . . . . . . . . . . *–3.0 0.6 *–3.0 0.9 *–2.4 0.8 *3.1 0.8

Louisiana . . . . . . . . . . . . . . . . *–2.0 0.7 *–2.9 0.8 *–2.2 0.9 *1.9 0.8

Maine . . . . . . . . . . . . . . . . . . . *–2.4 1.0 –1.0 1.1 –0.7 1.2 0.2 1.0

Maryland . . . . . . . . . . . . . . . . *–3.6 0.5 *–2.0 0.6 *–2.9 0.8 0.6 0.6

Massachusetts . . . . . . . . . . . . *–3.4 0.5 *–2.2 0.6 *–2.0 0.6 *0.8 0.4

Michigan . . . . . . . . . . . . . . . . *–4.9 0.4 *–2.8 0.4 *–2.8 0.5 *1.9 0.4

Minnesota . . . . . . . . . . . . . . . *–3.2 0.4 *–3.3 0.4 *–2.3 0.6 *0.6 0.4

Mississippi . . . . . . . . . . . . . . . *–4.8 0.8 *–1.6 1.0 *–1.6 1.2 *2.5 1.2

Missouri . . . . . . . . . . . . . . . . . *–3.5 0.4 *–2.9 0.6 *–1.3 0.7 0.5 0.6

Montana . . . . . . . . . . . . . . . . . *–2.1 1.2 *–3.4 1.5 –0.3 1.7 – 1.5

Nebraska . . . . . . . . . . . . . . . . *–2.2 0.6 *–3.5 0.9 *–2.9 1.2 *1.4 1.0

Nevada . . . . . . . . . . . . . . . . . *–5.5 0.7 *–5.9 0.9 *–3.4 1.1 *1.9 1.1

New Hampshire . . . . . . . . . . . *–2.9 0.9 *–1.9 1.3 –0.4 1.6 0.5 1.3

New Jersey . . . . . . . . . . . . . . *–4.3 0.4 *–1.8 0.5 *–2.6 0.6 *1.5 0.5

New Mexico . . . . . . . . . . . . . . *–4.4 1.0 *–1.5 1.3 *–1.8 1.3 –0.8 1.2

New York . . . . . . . . . . . . . . . . *–3.4 0.3 *–1.1 0.4 *–1.6 0.4 *0.5 0.4

North Carolina . . . . . . . . . . . . *–5.1 0.5 *–4.3 0.5 *–2.3 0.6 *1.9 0.6

North Dakota . . . . . . . . . . . . . *–1.2 0.9 –1.3 1.5 0.4 1.7 – 1.4

Ohio . . . . . . . . . . . . . . . . . . . . *–4.4 0.4 *–2.7 0.4 *–2.4 0.5 *1.3 0.4

Oklahoma . . . . . . . . . . . . . . . *–2.6 0.6 *–3.1 0.8 *–1.2 0.9 *0.9 0.9

Oregon . . . . . . . . . . . . . . . . . . *–5.1 0.7 *–4.1 0.9 *–2.3 0.9 *2.4 0.9

Pennsylvania . . . . . . . . . . . . . *–3.4 0.4 *–2.6 0.4 *–1.8 0.5 *1.4 0.4

Rhode Island . . . . . . . . . . . . . *–3.8 1.3 *–3.6 1.5 *–3.9 1.7 *2.7 1.5

South Carolina . . . . . . . . . . . . *–3.7 0.6 *–4.5 0.9 *–1.6 0.8 *1.6 0.7

South Dakota . . . . . . . . . . . . . *–2.6 1.0 *–3.3 1.5 *–2.6 1.8 1.4 1.4

Tennessee . . . . . . . . . . . . . . . *–4.7 0.5 *–3.4 0.8 *–2.3 0.8 *1.8 0.8

Texas . . . . . . . . . . . . . . . . . . . *–2.9 0.3 *–2.8 0.3 *–1.5 0.4 *1.5 0.3

Utah . . . . . . . . . . . . . . . . . . . . *–3.8 0.7 *–3.3 0.9 *–1.6 1.1 0.9 0.9

Vermont . . . . . . . . . . . . . . . . . *–3.0 1.1 *–2.7 1.6 *–2.7 1.5 –0.5 1.2

Virginia . . . . . . . . . . . . . . . . . . *–3.5 0.4 *–1.4 0.6 *–2.7 0.6 *1.8 0.5

Washington . . . . . . . . . . . . . . *–4.0 0.4 *–3.1 0.5 *–1.8 0.6 *2.3 0.6

West Virginia . . . . . . . . . . . . . *–4.0 1.0 *–1.2 1.2 0.4 1.7 –0.6 1.4

Wisconsin . . . . . . . . . . . . . . . *–3.5 0.4 *–4.0 0.5 *–2.6 0.7 0.5 0.5

Wyoming . . . . . . . . . . . . . . . . *–2.1 1.3 *–4.0 1.8 –0.8 2.4 1.3 2.1

Puerto Rico . . . . . . . . . . . . . . *–1.8 0.7 –0.1 1.1 *–2.2 1.2 *0.9 0.4

– Represents or rounds to zero.

* Statistically different from zero at the 90 percent confidence level. 1

A margin of error is a measure of an estimate’s variability. The larger the margin of error in relation to the size of the estimate, the less reliable the estimate. For further 

information on the accuracy of the estimates, including standard errors and margins of error, please see the ACS and PRCS “Accuracy of the Data” for 2008 and 2010 at 

<www.census.gov/acs/www/data_documentation/documentation_main/>.

Sources: U.S. Census Bureau, 2008 and 2010 American Community Surveys, 2008 and 2010 Puerto Rico Community Surveys.
U.S. Census Bureau 5

percent of workers had employerbased health insurance in 2010, 

down from 69.2 percent in 2008 

(Table 1). The drop in employerbased health insurance was mitigated, in part, by a 0.7 percentage 

point increase in the proportion of 

workers with non-employer-based 

health insurance coverage. About 

12.3 percent of workers had nonemployer-based coverage in 2008, 

compared with 13.0 percent in 

2010. Consequently, the uninsured 

rate for workers increased 1.4 

percentage points over this 

time period. 

Details concerning the decline in 

employer-based health insurance 

emerge when work experience (the 

summary of usual hours and weeks 

worked in the past year) is taken 

into account. Among full-time, 

year-round workers, 77.6 percent 

had employer-based insurance in 

2010, down from 77.8 percent in 

2008. The incidence of employerbased health insurance coverage 

fell by 0.2 percentage points, offset 

by a 0.3 percentage point increase 

in non-employer-based health 

insurance coverage; there was no 

statistically significant difference 

in the uninsured rate for full-time, 

year-round workers between the 

two periods.

For workers who reported working less than full time, year round, 

the incidence of employer-based 

health insurance coverage declined 

3.3 percentage points from 52.8 

percent to 49.6 percent. Unlike 

full-time, year-round workers, the 

increase in non-employer-based 

health insurance coverage was 

not enough to compensate for the 

decline in employer-based health 

insurance. Instead, the uninsured rate for less than full-time, 

Figure 2. 

Change in Percentage of Workers Who Worked Full Time, Year Round by the 

Change in Percentage of Workers With Employer-Based Health Insurance for 

the United States and States: 2008 to 2010

Note: Each blue data point represents a state; the United States is represented by a red data point.

Sources: U.S. Census Bureau, 2008 and 2010 American Community Surveys.

Change in percentage of workers that worked full time, year round

Change in percentage of workers with employer-based health insurance 

AR

– 5.0

– 4.0

– 3.0

– 2.0

 1.0 – 

0.0

1.0

2.0

–7.0 – 6.0 – 5.0 – 4.0 –3.0 –2.0 –1.0 0.0 1.0 2.0
6 U.S. Census Bureau

year-round workers increased 2.9 

percentage points. 

The relative stability of employerbased health insurance coverage 

among full-time, year-round workers suggests that the reduction in 

the coverage rate for all workers 

was driven by changes in the relative size and coverage rate of less 

than full-time, year-round workers. 

Changes in employer-based health 

insurance coverage were likely 

associated with full-time job loss 

and the transitions of employees 

into part-time or temporary work, 

for whom employers typically do 

not offer equally comprehensive 

benefits.5

EMPLOYER-BASED HEALTH 

INSURANCE COVERAGE 

AMONG STATES

In addition to implementing and 

enforcing federal rules relating to 

work and health insurance coverage, state governments also 

direct the manner under which 

the states’ labor markets operate. 

These regulations on topics such 

as licensure, unionization, and 

5 According to the Kaiser Family Foundation (2010), 25 percent of employers offered 

health benefits to part-time employees, and 2 

percent offered health benefits to temporary 

employees. About 69 percent of employers 

offered health benefits overall (Exhibits 2.3, 

2.5, and 2.6, Employer Health Benefits Survey 

2010, Kaiser Family Foundation, <http://

ehbs.kff.org/pdf/2010/8085.pdf>).

employee benefits can and often 

differ between states. The resulting population and labor market 

characteristics may explain some 

of the variation in employer-based 

health insurance coverage as well 

as the change in health insurance 

coverage over time.6

As shown in Figure 1, 

Massachusetts had among 

the highest rates of employerbased health insurance coverage 

for both people who worked full 

time, year round and those who 

worked less than full time, year 

round in 2010 (86.4 and 62.6 

6 Shen, Yu-Chu and Stephen Zuckerman, 

“Why is There State Variation in EmployerSponsored Insurance,” Health Affairs, 22, No. 

1 (2003): 241–251.

Figure 3.

Change in Percentage of Full-Time, Year-Round Workers With 

Employer-Based Health Insurance for States and Puerto Rico: 

2008 to 2010

U.S. estimate: Decreased (–0.2%)

Percent 

Greater than 1.0 

0.0 to 1.0 

–1.0 to 0.0 

Less than –1.0

* Significant changes

Source: U.S. Census Bureau, 2008 and 2010 American Community Surveys, 

2008 and 2010 Puerto Rico Community Surveys.

MT

AK

NM

OR MN

KS*

SD

ND

MO*

WA

FL*

IL* IN

WI* NY*

PA

MI*

OH*

IA

ME

MA 

CT* 

AZ*

NV

TX*

CA CO*

WY

UT*

ID*

NE*

OK*

GA

AR*

AL*

NC

MS

LA

TN

KY*

VA*

SC

WV

RI 

DE 

MD* 

NJ* 

HI*

VT NH

PR

DC *
U.S. Census Bureau 7

percent, respectively).7 New 

Mexico, on the other hand, had 

among the lowest rates for both 

groups (67.8 and 39.0 percent, 

respectively).8 Twenty-seven states 

and the District of Columbia had 

employer-based coverage rates for 

full-time, year-round workers that 

were above the national average 

7 The employer-based health insurance 

coverage rates for full-time, year-round workers in Massachusetts was not statistically different from the rate in Hawaii. The employerbased health insurance coverage rates for 

less than full-time, year-round workers in 

Massachusetts was not statistically different 

from the rate in New Hampshire. 8 The employer-based health insurance 

coverage rates for less than full-time, yearround workers in New Mexico was not statistically different from the rate in Florida.

of 77.6 percent.9 The association 

between coverage for full-time, 

year-round and less than full-time, 

year-round workers is not necessarily reflective of the differences in 

the level of benefits offered to parttime or temporary workers, but 

rather may be indicative of coverage through a full-time, year-round 

parent or spouse.

As shown in Table 2, the percentage of the population who reported 

working in the past 12 months 

decreased for all 50 states and the 

District of Columbia between 2008 

and 2010, while the percentage of 

9 The employer-based health insurance 

coverage rates among full-time, year-round 

workers in Nebraska, North Dakota, 

Tennessee, Vermont, and Wyoming were not 

statistically different from the U.S. estimate.

workers who worked full time, year 

round decreased for 47 states.10

The percentage of workers with 

employer-based health insurance 

coverage decreased for 41 states. 

The magnitude of these decreases 

ranged from 0.9 to 3.9 percentage points. Nine states and the 

District of Columbia experienced 

no statistical change in the rate of 

employer-based health insurance 

coverage among workers. 

Among all workers, states with 

greater declines in the percentage of full-time, year-round workers were typically associated with 

10 There was no statistically significant 

difference in the percentage working full 

time, year round between the 2 years for 

Alaska, Maine, North Dakota, and the District 

of Columbia. 

Figure 4.

Change in Percentage of Full-Time, Year-Round Workers Without 

Health Insurance for States and Puerto Rico: 2008 to 2010

U.S. estimate: No statistically 

significant change (–0.1%)

Percent 

Greater than 1.0 

0.0 to 1.0 

–1.0 to 0.0 

Less than –1.0

* Significant changes

Source: U.S. Census Bureau, 2008 and 2010 American Community Surveys, 

2008 and 2010 Puerto Rico Community Surveys.

MT*

AK

NM*

OR MN*

KS*

SD

ND

MO*

WA

FL

IL* IN

WI NY

PA

MI*

OH

IA

ME*

MA 

CT 

AZ*

NV

TX

CA CO*

WY

UT*

ID*

NE

OK*

GA

AR

AL

NC

MS

LA

TN

KY*

VA*

SC

WV

RI 

DE 

MD 

NJ* 

HI*

VT NH

PR

DC 
8 U.S. Census Bureau

greater declines in employer-based 

health insurance coverage (Figure 2 and Table 2). For example, 

in Nevada, the percentage of 

workers working full time, year 

round decreased by 5.9 percentage points, while the percentage 

of workers with employer-based 

health insurance coverage fell by 

3.4 percentage points. Conversely, 

in New York, where the percentage 

of workers working full time, year 

round fell by 1.1 percentage points, 

the percentage with employerbased health insurance coverage 

decreased 1.6 percentage points. 

This evidence is consistent with the 

understanding that employer-based 

health insurance coverage is often 

tied to full-time employment.

Employer-based health insurance 

coverage for full-time, year-round 

workers decreased modestly for 

the nation (0.2 percentage points), 

but among states, changes in the 

percentage with employer-based 

health insurance varied, ranging 

from decreases of 2.0 percentage points to increases of 3.2 

percentage points. As shown in 

Figure 3, states with increases in 

employer-based health insurance 

coverage were typically west of 

the Mississippi river, while states 

with decreases in coverage were 

typically in the eastern part of the 

United States.

At the state-level, the role that 

non-employer-based coverage contributed to overall coverage varied 

from counterbalancing the declines 

in employer-based health insurance coverage to contributing to 

further increases in the percentage 

without health insurance (Table 2). 

The uninsured rate among workers increased in 31 states between 

2008 and 2010. There was no 

statistically significant difference in 

the uninsured rate for workers in 

19 states and the District 

of Columbia. 

The change in the uninsured rate 

for full-time, year-round workers 

also varied across states (Figure 

4). While there was no statistically 

significant change in the uninsured 

rate at the national level, the rate 

decreased for 10 states: Arizona, 

Colorado, Idaho, Maine, Minnesota, 

Missouri, Montana, New Mexico, 

Oklahoma, and Utah. At the same 

time, the uninsured rate for fulltime, year-round workers increased 

in 6 states: Illinois, Kansas, 

Kentucky, Michigan, New Jersey 

and Virginia. As shown in Figure 4, 

states with decreases in the uninsured rate among full-time, yearround workers were typically in the 

west while those with increases 

were typically in the eastern half 

of the country. In fact, all six states 

with increases in the uninsured 

rate for full-time, year-round workers also experienced decreases 

in employer-based health insurance. Five of the ten states with 

decreases in the uninsured rate had 

increases in their rates of employerbased health insurance coverage.11

11 Arizona, Colorado, Idaho, Missouri, 

and Utah experienced statistically significant 

increases in the rate of employer-based health 

insurance coverage and decreases in the 

uninsured rate among full-time, year-round 

workers.

MORE INFORMATION

For more information about health 

insurance coverage in the United 

States, go to the U.S. Census 

Bureau Web site on Health Insurance at <www.census.gov/hhes

/www/hlthins/hlthins.html> or 

contact the Health and Disability 

Statistics Branch of the U.S. Census 

Bureau at 301-763-9112 or e-mail 

<matthew.w.brault@census.gov>.

SOURCE AND ACCURACY

Data presented in this report are 

based on people and households 

that responded to the ACS in 2008 

and 2010. The resulting estimates 

are representative of the civilian 

noninstitutionalized population. 

All comparisons presented in this 

report have taken sampling error 

into account and are significant 

at the 90 percent confidence level 

unless otherwise noted. Due to 

rounding, some details may not 

sum to totals. For information on 

sampling and estimation methods, 

confidentiality protection, and 

sampling and nonsampling errors, 

please see the “ACS Accuracy of 

the Data” documents for 2008 and 

2010 located at <www.census.gov

/acs/www/data_documentation

/documentation_main/>.

WHAT IS THE AMERICAN COMMUNITY SURVEY?

The American Community Survey (ACS) is a nationwide survey designed to provide communities with reliable and timely 

demographic, social, economic and housing data for the nation, 

states, congressional districts, counties, places, and other localities every year. It has an annual sample size of about 3 million 

addresses across the United States and Puerto Rico and includes 

both housing units and group quarters (e.g., nursing facilities 

and prisons). The ACS is conducted in every county throughout the nation, and every municipio in Puerto Rico, where it is 

called the Puerto Rico Community Survey. Beginning in 2006, ACS 

data for 2005 were released for geographic areas with populations of 65,000 and greater. For information on the ACS sample 

design and other topics, visit <www.census.gov/acs/www>.