A 2005 Commonwealth Fund white paper reported on two important trends in the U.S. workforce – the increasing prevalence of workers in part-time, temporary, contract or non-standard positions, and the decline in access to employer-provided health insurance.
The fact that fewer and fewer individuals in Dallas, Houston and throughout Texas are covered by health insurance as well as the diminished quality of coverage brought about by higher copayments and deductibles has gotten a lot of attention. At the same time, there has been remarkably little attention paid to the status of nonstandard workers, who are particularly vulnerable because their employment status often excludes them from employer-based coverage. This increases their reliance on family members’ policies, public coverage or leaves them without insurance completely.
Nonstandard workers currently make up approximately 25 percent of the nation’s workforce, totaling 34.3 million workers. Part-time workers make up the biggest category within this group, followed by self-employed independent contractors and direct-hire temporary workers. Nonstandard workers also include on-call and day laborers, temporary help agency workers, independent contractors, and contract company workers.
While access to employer-sponsored health insurance is on the decline for all workers, it is an especially serious problem for nonstandard workers. A recent study showed that 74 percent of standard workers have health insurance through their jobs, compared to only 21 percent of nonstandard workers. Because of this disparity, nonstandard workers are thought to be uninsured at twice the rate of standard workers. Nonstandard workers also rely on government insurance at five times the rate of regular workers and are insured through a spouse’s health insurance plan at three and one-half times the rate of regular workers.
In addition to being less likely to be offered employer-sponsored health insurance, nonstandard workers are also less likely to take up employer-sponsored coverage when it is available. About 87 percent of regular full-time workers are offered health insurance, compared with only 40 percent of nonstandard workers. Among those nonstandard workers who are eligible for employer-based plans, only 54 percent choose them, while the selection rate for standard workers is 85 percent. Nonstandard workers who turn down coverage said it was either because they had coverage through another source or because the plan was too expensive.