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Small Businesses and Health Coverage


  • Employer-sponsored health insurance (ESI) is the predominant form of insurance coverage for the under-65 population and declines in ESI were the leading force behind the declines in overall health insurance coverage from 2000 to 2007. The proportion of Americans covered by ESI dropped by more than 5 percentage points between 2000 and 2007 (from 64.2 percent of adult Americans in 2000 to 59.3 percent in 2007).
  • Although workers in firms of all sizes lost coverage, those in smaller firms had greater declines since 2000.
  • Since 2001, the percentage of Virginians without health insurance has increased from 9.9 percent to 14.8 percent.
  • Based on U.S Census Bureau Current Population Survey, Annual Social and Economic Supplement, 2008, over 70 percent of the uninsured are employed, and 43.5 percent or 390,827 uninsured Virginians are employed full-time year-round. Among employed individuals age 19-64, the uninsured rate was two to three times higher for people employed in firms with 50 or fewer employees than for people in firms with 51 or more employees.
  • According to the Virginia Employment Commission (2nd Quarter 2008), there are 151,612 small firms with less than 50 employees in the state. An estimated 79 percent of individuals employed in firms with more than 50 employees were offered health coverage, compared to 64 percent in firms with 11-50 employees, and 32 percent in firms with <11 employees.
  • The following facts are taken from the Commonwealth Institute for Fiscal Analysis report “Feeling the Pinch: The State of Working Virginia”released in September 2008:
  • According to Census Bureau data, 61.9 percent of Virginia’s workers received health insurance through their employer in 2007, a substantial decline from the 66.7 percent of Virginians in 2006.
  • Virginia workers’ share of the total premium cost for individual health insurance coverage rose, on average, from 20.1 percent in 2005 to 24.0 percent (an average of $982 a year) in 2006.
  • In 2006, Virginia had the highest average employee contribution costs for single health insurance plans in the nation, after ranking 18th in 2005. Workers with family coverage paid 31.3 percent of the total premium costs, the third highest percentage in the country.

The following factoids are taken from the Families USA report “Premiums versus Paychecks: A Growing Burden for Virginia’s Workers”released in September 2008:

  • Between 2000 – 2007, for individual health coverage in Virginia, the average annual premium (employer and worker share of premiums combined) rose from $2,574 to $4,341, an increase of $1,767.
  • Between 2000 and 2007, for family health coverage in Virginia, the average annual premium (employer and worker share of premiums combined) rose from $6,684 to $12,198, an increase of $5,514.
  • Average health premiums for family coverage rose 4.1 times faster than median earnings from 2000 to 2007.

Last Updated: 05-16-2013

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