“Loads of instances, well being care comes with a job.”
Sen. John Thune (R-S.D.), in an interview with KOTA on Could 30, 2025
Thousands and thousands of persons are anticipated to lose entry to Medicaid and Inexpensive Care Act market medical health insurance plans if federal lawmakers approve the One Large Stunning Invoice Act, President Donald Trump’s home coverage bundle, which is now transferring via the Senate.
Senate Majority Chief John Thune mentioned well being care and the pending laws in an interview with KOTA, a South Dakota TV station. However he targeted on a special form of medical health insurance — employer-sponsored insurance coverage.
“Loads of instances, well being care comes with a job,” Thune stated.
Thune’s feedback within the interview have been made within the context of highlighting a part of the GOP’s financial coverage goal. “Creating these better-paying jobs that include advantages is in the end the objective right here,” he stated.
KFF Well being Information reached out to Thune’s workplace to search out out the idea for this remark. His communications director, Ryan Wrasse, responded by reiterating Thune’s message: “Getting a job has the potential to steer a employee to buying well being care.”
Paul Fronstin, director of well being advantages analysis on the Worker Profit Analysis Institute, stated Thune’s remark might also be alluding to discussions surrounding Medicaid work necessities. The One Large Stunning Invoice Act would let nondisabled adults enroll in Medicaid provided that they show they’re volunteering, working, or looking out or coaching for work.
Medicaid, funded by the federal authorities and states, is the nation’s principal medical health insurance program for folks with low incomes. Some folks with disabilities additionally qualify.
Some Republicans have constructed on the roles speaking level in defending the Medicaid cuts and work necessities. Sen. James Lankford (R-Okla.), for example, advised CNBC the invoice isn’t about “kicking folks off Medicaid. It’s transitioning from Medicaid to employer-provided well being care.”
However the well being coverage specialists we checked with made clear that getting a job isn’t a assure for getting work-sponsored insurance coverage.
Employer-Sponsored Well being Insurance coverage: The Fundamentals
These specialists stated most jobs do provide medical health insurance. However additionally they stated the hyperlink between employment and work-based protection isn’t all the time easy.
“After I see this assertion, I’m like, ‘I’ve bought a lot extra to say about this.’ However I’m not arguing with the assertion,” Fronstin stated.
Matthew Rae, an affiliate director targeted on researching personal insurance coverage at KFF, a well being info nonprofit that features KFF Well being Information, additionally weighed in.
“Employer-sponsored protection stays the bedrock of how folks get medical health insurance in the US,” Rae stated. “I’d say that getting a job isn’t a assure you’re going to have medical health insurance. It simply will increase your possibilities of getting it.”
About 60% of People youthful than 65 obtain medical health insurance via their job or because the partner, youngster, or different dependent of somebody insured via their work, in response to 2023 KFF knowledge.
Amongst employees ages 18 to 64 who have been eligible however didn’t join their office insurance coverage, 28% stated the rationale they determined to not enroll was that the plans have been too costly, 2023 KFF knowledge confirmed.
Most of those employees discovered medical health insurance elsewhere, corresponding to via a relative’s office plan. However a small proportion of eligible staff, 3.7%, have been uninsured.
Medical health insurance has been “probably the most valued profit within the office” since companies started providing it to recruit staff in a good labor market throughout World Struggle II, Fronstin stated.
Federal legislation additionally encourages firms to supply plans. Beneath the Inexpensive Care Act, employers with 50 or extra full-time employees are penalized in the event that they don’t provide most staff insurance coverage that the federal authorities considers reasonably priced.
As of final 12 months, 54% of firms supplied medical health insurance to at the least some staff, in response to KFF.
However that’s not the principle means the ACA helped decrease the speed of individuals with out medical health insurance, stated Melissa Thomasson, a professor at Miami College in Ohio who specializes within the financial historical past of medical health insurance. “Practically all of that” change, she stated, got here from the ACA creating personal market plans and permitting states to broaden Medicaid eligibility.
Well being coverage analysts say the One Large Stunning Invoice would make it harder for folks to qualify or afford market plans, with proposals that will enhance paperwork, shorten enrollment intervals, and permit enhanced tax credit to fizzle out. Thomasson additionally famous that political rhetoric surrounding jobs and medical health insurance doesn’t all the time align.
“We frequently speak about small companies being the engine of job creation,” however these are the companies that usually can’t afford to supply office insurance coverage, she stated.
So Who Isn’t Insured Via Office Insurance coverage?
The obvious class of people that don’t have office insurance coverage are those that don’t have a job. This group consists of youngsters and retirees, folks looking for work, individuals who select to not work, and people who can’t work, due to a incapacity or sickness.
One other group with out employer-provided insurance coverage is the 25% of individuals ages 18 to 64 who’ve a job however are unable to acquire such insurance coverage, in response to 2023 knowledge from KFF.
A few of these folks work for firms that don’t provide medical health insurance. These employers are usually small companies or a part of sure industries, corresponding to farming and development.
Others are part-time, non permanent, or seasonal employees at firms that provide medical health insurance solely to full-time staff. Staff with low incomes are considerably much less seemingly than these with increased incomes to be eligible for office insurance coverage, in response to 2023 KFF knowledge.
Individuals who aren’t employed or don’t get insurance coverage via their job can get protection in different methods. Some are insured via a relative’s office plan, whereas others buy plans and should qualify for subsidies on the ACA market.
Others get insurance coverage via Medicaid or Medicare, the federal medical health insurance program for folks 65 or older and a few folks with disabilities.
Value and High quality — And Subsequently Entry to Care — Differ
Simply because somebody has medical health insurance doesn’t imply they’ll get the well being care they want. Individuals could skip or delay care if their plans are unaffordable or in the event that they restrict in-network suppliers.
“Well being advantages are available all styles and sizes,” Fronstin stated. “Some employers provide very beneficiant advantages, and others much less so.”
KFF knowledge reveals that premiums and enrollees’ cost-sharing bills grew quicker than wages from 2008 to 2018 however have slowed lately.
Whether or not office insurance coverage is reasonably priced considerably varies by revenue. In line with 2020 KFF knowledge, lower-income households insured via a full-time employee spent, on common, 10.4% of their revenue on premiums and out-of-pocket prices. That’s greater than twice the speed when taking a look at households throughout all incomes.
Our Ruling
Thune stated, “Loads of instances, well being care comes with a job.”
This assertion is partially correct. Most employees within the U.S. get well being protection via work. But it surely glosses over facets of our nation’s job-based medical health insurance system — corresponding to how prices and protection, particularly for these with decrease incomes, could make an employer plan out of attain even whether it is accessible.
Backside line: Not all jobs present medical health insurance or provide plans to all their employees. After they do, price and high quality fluctuate broadly — making Thune’s assertion an oversimplification.
We charge this assertion Half True.
Sources
KOTA interview with Sen. John Thune, Could 30, 2025.
CNBC interview with Sen. James Lankford, June 5, 2025.
KFF, “2024 Employer Well being Advantages Survey,” Oct. 9, 2024.
KFF, “Employer Accountability Beneath the Inexpensive Care Act,” Feb. 29, 2024.
KFF, “Employer-Sponsored Well being Insurance coverage 101,” Could 28, 2024.
Peterson-KFF Well being System Tracker, “What Are the Current Developments in Employer-Based mostly Well being Protection?” Dec. 22, 2023.
Peterson-KFF Well being System Tracker, “How Affordability of Employer Protection Varies by Household Revenue,”March 10, 2022.
Peterson-KFF Well being System Tracker, “Monitoring the Rise in Premium Contributions and Value-Sharing for Households With Massive Employer Protection,” Aug. 14, 2019.
Manhattan Institute, “Put Staff in Management of Well being Insurance coverage with ‘Employee’s Selection ICHRA,’” Could 22, 2025.
Brookings, “Uninsurance Charges Have Fallen Considerably Following the Inexpensive Care Act,” July 22, 2024.
Harvard Enterprise Evaluation, “Why Do Employers Present Well being Care within the First Place?” March 15, 2019.
Congressional Finances Workplace letter on the One Large Stunning Invoice Act growing the variety of uninsured folks, June 4, 2025.
Telephone interview with Paul Fronstin, director of well being advantages analysis on the Worker Profit Analysis Institute and a member of the Commonwealth Fund’s Nationwide Activity Power on the Future Function of Employers within the U.S. Well being System, June 6, 2025.
Telephone interview with Melissa Thomasson, professor and well being economist at Miami College, June 6, 2025.
Telephone interview with Maanasa Kona, affiliate analysis professor on the Middle on Well being Insurance coverage Reforms at Georgetown College, June 6, 2025.
Telephone interview with Matthew Rae, affiliate director for the Well being Care Market Program at KFF, June 10, 2025.
Telephone interview with Sally Pipes, president and CEO of the Pacific Analysis Institute, June 11, 2025.
E-mail correspondence with Ryan Wrasse, communications director for Sen. John Thune, June 10, 2025.
KFF Well being Information, “Some Employers Check Association To Give Staff Allowance for Protection,” Oct. 2, 2024.
KFF Well being Information, “Trump’s ‘One Large Stunning Invoice’ Continues Assault on Obamacare,” June 3, 2025.
KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is likely one of the core working packages at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Study extra about KFF.
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