“Loads of occasions, well being care comes with a job.”
Sen. John Thune (R-S.D.), in an interview with KOTA on Might 30, 2025
Thousands and thousands of individuals are anticipated to lose entry to Medicaid and Inexpensive Care Act market medical insurance plans if federal lawmakers approve the One Large Lovely Invoice Act, President Donald Trump’s home coverage package deal, which is now shifting by means of 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 insurance — employer-sponsored insurance coverage.
“Loads of occasions, well being care comes with a job,” Thune mentioned.
Thune’s feedback within the interview had 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 purpose right here,” he mentioned.
KFF Well being Information reached out to Thune’s workplace to search out out the premise for this remark. His communications director, Ryan Wrasse, responded by reiterating Thune’s message: “Getting a job has the potential to guide a employee to buying well being care.”
Paul Fronstin, director of well being advantages analysis on the Worker Profit Analysis Institute, mentioned Thune’s remark may additionally be alluding to discussions surrounding Medicaid work necessities. The One Large Lovely 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 most important medical 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.), as an illustration, informed 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 consultants 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 consultants mentioned most jobs do supply medical insurance. However in addition they mentioned the hyperlink between employment and work-based protection just isn’t all the time simple.
“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 mentioned.
Matthew Rae, an affiliate director targeted on researching non-public insurance coverage at KFF, a well being data nonprofit that features KFF Well being Information, additionally weighed in.
“Employer-sponsored protection stays the bedrock of how folks get medical insurance in the USA,” Rae mentioned. “I might say that getting a job just isn’t a assure you’re going to have medical insurance. It simply will increase your possibilities of getting it.”
About 60% of Individuals youthful than 65 obtain medical insurance by means of their job or because the partner, youngster, or different dependent of somebody insured by means of their work, in keeping with 2023 KFF information.
Amongst staff ages 18 to 64 who had been eligible however didn’t join their office insurance coverage, 28% mentioned the rationale they determined to not enroll was that the plans had been too costly, 2023 KFF information confirmed.
Most of those staff discovered medical insurance elsewhere, comparable to by means of a relative’s office plan. However a small share of eligible staff, 3.7%, had been uninsured.
Medical health insurance has been “essentially the most valued profit within the office” since companies started providing it to recruit staff in a good labor market throughout World Warfare II, Fronstin mentioned.
Federal legislation additionally encourages firms to supply plans. Below the Inexpensive Care Act, employers with 50 or extra full-time staff are penalized in the event that they don’t supply most staff insurance coverage that the federal authorities considers inexpensive.
As of final yr, 54% of firms provided medical insurance to at the very least some staff, in keeping with KFF.
However that’s not the principle means the ACA helped decrease the speed of individuals with out medical insurance, mentioned Melissa Thomasson, a professor at Miami College in Ohio who specializes within the financial historical past of medical insurance. “Almost all of that” change, she mentioned, got here from the ACA creating non-public market plans and permitting states to develop Medicaid eligibility.
Well being coverage analysts say the One Large Lovely Invoice would make it tougher for folks to qualify or afford market plans, with proposals that might enhance paperwork, shorten enrollment intervals, and permit enhanced tax credit to fizzle out. Thomasson additionally famous that political rhetoric surrounding jobs and medical insurance doesn’t all the time align.
“We regularly speak about small companies being the engine of job creation,” however these are the companies that always can’t afford to supply office insurance coverage, she mentioned.
So Who Isn’t Insured By means of 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 contains youngsters and retirees, folks trying to find 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 keeping with 2023 information from KFF.
A few of these folks work for firms that don’t supply medical insurance. These employers are usually small companies or a part of sure industries, comparable to farming and development.
Others are part-time, momentary, or seasonal staff at firms that provide medical 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 keeping with 2023 KFF information.
Individuals who aren’t employed or don’t get insurance coverage by means of their job can get protection in different methods. Some are insured by means of a relative’s office plan, whereas others buy plans and should qualify for subsidies on the ACA market.
Others get insurance coverage by means of Medicaid or Medicare, the federal medical 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 insurance doesn’t imply they’ll get the well being care they want. Folks might 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 sizes and styles,” Fronstin mentioned. “Some employers supply very beneficiant advantages, and others much less so.”
KFF information reveals that premiums and enrollees’ cost-sharing bills grew sooner than wages from 2008 to 2018 however have slowed lately.
Whether or not office insurance coverage is inexpensive considerably varies by revenue. In line with 2020 KFF information, lower-income households insured by means of 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 mentioned, “Loads of occasions, well being care comes with a job.”
This assertion is partially correct. Most staff within the U.S. get well being protection by means of work. But it surely glosses over points of our nation’s job-based medical insurance system — comparable to how prices and protection, particularly for these with decrease incomes, could make an employer plan out of attain even whether it is obtainable.
Backside line: Not all jobs present medical insurance or supply plans to all their staff. After they do, price and high quality fluctuate extensively — making Thune’s assertion an oversimplification.
We fee this assertion Half True.
Sources
KOTA interview with Sen. John Thune, Might 30, 2025.
CNBC interview with Sen. James Lankford, June 5, 2025.
KFF, “2024 Employer Well being Advantages Survey,” Oct. 9, 2024.
KFF, “Employer Duty Below the Inexpensive Care Act,” Feb. 29, 2024.
KFF, “Employer-Sponsored Well being Insurance coverage 101,” Might 28, 2024.
Peterson-KFF Well being System Tracker, “What Are the Current Tendencies in Employer-Based mostly Well being Protection?” Dec. 22, 2023.
Peterson-KFF Well being System Tracker, “How Affordability of Employer Protection Varies by Household Earnings,”March 10, 2022.
Peterson-KFF Well being System Tracker, “Monitoring the Rise in Premium Contributions and Value-Sharing for Households With Giant Employer Protection,” Aug. 14, 2019.
Manhattan Institute, “Put Staff in Management of Well being Insurance coverage with ‘Employee’s Alternative ICHRA,’” Might 22, 2025.
Brookings, “Uninsurance Charges Have Fallen Considerably Following the Inexpensive Care Act,” July 22, 2024.
Harvard Enterprise Evaluate, “Why Do Employers Present Well being Care within the First Place?” March 15, 2019.
Congressional Finances Workplace letter on the One Large Lovely 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 Process Pressure on the Future Position 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 Heart 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.
Electronic mail correspondence with Ryan Wrasse, communications director for Sen. John Thune, June 10, 2025.
KFF Well being Information, “Some Employers Take a look at Association To Give Staff Allowance for Protection,” Oct. 2, 2024.
KFF Well being Information, “Trump’s ‘One Large Lovely Invoice’ Continues Assault on Obamacare,” June 3, 2025.
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