When Workers Don’t Have Employer-Sponsored Health Insurance

Many employers are getting ready to begin open enrollment for their employees’ 2025 health benefits coverage. But what happens when workers don’t have employer-sponsored health insurance? Several shared their experience.

• A major retailer hired temporary seasonal workers during the Christmas holiday. These workers did not work enough hours to qualify for the company’s health benefits plan. One seasonal worker commented that she loved the flexibility and income, but “I couldn’t work here if I didn’t have a Medicare Advantage plan.”
• A ride-sharing company did not provide health insurance to its drivers. They were considered independent contractors not employees. One driver’s income was such that she was covered by Medicaid. She was happy with the benefits and doctors but described “the paperwork” as confusing.
• A non-profit organization grew quickly from a handful of volunteers to 50 full-time employees. It had not implemented an employee benefits plan yet. The organization reimbursed employees who obtained coverage on the Affordable Care Act’s (ACA’s) federal marketplace. Employees said “it was better nothing.”

The U.S. is the only industrialized country where workers depend on their employers for coverage. Workers who don’t have employer-sponsored health insurance may obtain coverage through one of the country’s other systems, such as ACA, Medicaid, or Medicare. In other words, these consumers were Mastering Health Insurance.

Photo: 17 ducks in a row