By NextBestFitPeople with employer coverage
Workers and their families insured through a job. Many like their plans, and they are usually seen fastest today.
Size: 178.6 million people (2024)
Sources: CMS Office of the Actuary (2025)
Under your mix of paths
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Problems that hurt them
Paths that fix these help them.
- Surprise billing and a runaway arbitration system: Premiums fund the higher arbitration awards.
- Insurer overhead and profit: Premiums pay for insurer overhead and profit.
- U.S. prices are far higher than in other countries: Private plans pay the highest prices, passed on through premiums.
- Hospital and physician consolidation raises prices: Consolidation raises commercial prices without clear quality gains.
- About $1 trillion a year in administrative cost: Premiums pay for the administration.
- Fraud and improper payments: Fraud and improper payments consume public funds and premiums.
- Cyberattacks can halt payments and care: Cyberattacks expose personal health data.
- Longer waits if demand grows faster than capacity: They are seen fastest today and would share one queue with everyone.
- Transition disruption: jobs, companies, and familiar coverage: People leave plans most of them rate well, and must re-learn how coverage works.
- Losing the choice of health plan and insurer competition: They can't keep or pick a plan they like, or switch if service is poor.
Problems they gain from
Paths that fix these cost them.
- Employer health taxes can lower wages at firms that never offered coverage: Savings at firms that offered expensive coverage can raise workers’ wages.