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Monday, June 30, 2025

Thune Says Well being Care Typically ‘Comes With a Job.’ The Actuality’s Not Easy or Easy.


“Quite a lot of occasions, well being care comes with a job.”

Sen. John Thune (R-S.D.), in an interview with KOTA on Might 30, 2025

Tens of millions of individuals are anticipated to lose entry to Medicaid and Reasonably priced Care Act market medical health insurance plans if federal lawmakers approve the One Massive Lovely Invoice Act, President Donald Trump’s home coverage package deal, which is now shifting by 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 distinct type of medical health insurance — employer-sponsored insurance coverage.

“Quite a lot of occasions, well being care comes with a job,” Thune mentioned.

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 purpose right here,” he mentioned.

KFF Well being Information reached out to Thune’s workplace to seek 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 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 might also be alluding to discussions surrounding Medicaid work necessities. The One Massive 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 fundamental 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.), as an example, 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 health insurance. However additionally they mentioned the hyperlink between employment and work-based protection just isn’t all the time easy.

“After I see this assertion, I’m like, ‘I’ve obtained 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 personal 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 health insurance in the USA,” Rae mentioned. “I’d say that getting a job just 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 by their job or because the partner, little one, or different dependent of somebody insured by their work, in line with 2023 KFF knowledge.

Amongst employees ages 18 to 64 who have been eligible however didn’t join their office insurance coverage, 28% mentioned 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, reminiscent of by a relative’s office plan. However a small share of eligible staff, 3.7%, have 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 decent labor market throughout World Battle II, Fronstin mentioned.

Federal legislation additionally encourages corporations to supply plans. Beneath the Reasonably priced Care Act, employers with 50 or extra full-time employees are penalized in the event that they don’t supply most staff insurance coverage that the federal authorities considers reasonably priced.

As of final 12 months, 54% of corporations supplied medical health insurance to a minimum of some staff, in line with KFF.

However that’s not the primary means the ACA helped decrease the speed of individuals with out medical health insurance, mentioned 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 mentioned, got here from the ACA creating personal market plans and permitting states to increase Medicaid eligibility.

Well being coverage analysts say the One Massive Lovely Invoice would make it tougher for folks to qualify or afford market plans, with proposals that will enhance paperwork, shorten enrollment durations, 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 regularly discuss small companies being the engine of job creation,” however these are the companies that usually can’t afford to supply office insurance coverage, she mentioned.

So Who Isn’t Insured By 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 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 line with 2023 knowledge from KFF.

A few of these folks work for corporations that don’t supply medical health insurance. These employers are typically small companies or a part of sure industries, reminiscent of farming and building.

Others are part-time, non permanent, or seasonal employees at corporations that provide medical health insurance solely to full-time staff. Employees with low incomes are considerably much less seemingly than these with increased incomes to be eligible for office insurance coverage, in line with 2023 KFF knowledge.

Individuals who aren’t employed or don’t get insurance coverage by their job can get protection in different methods. Some are insured by a relative’s office plan, whereas others buy plans and will qualify for subsidies on the ACA market.

Others get insurance coverage by Medicaid or Medicare, the federal medical health insurance program for folks 65 or older and a few folks with disabilities.

Price and High quality — And Due to this fact Entry to Care — Range

Simply because somebody has medical health insurance doesn’t imply they’ll get the well being care they want. Individuals 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 in all styles and sizes,” Fronstin mentioned. “Some employers supply very beneficiant advantages, and others much less so.”

KFF knowledge exhibits 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 reasonably priced considerably varies by earnings. In keeping with 2020 KFF knowledge, lower-income households insured by a full-time employee spent, on common, 10.4% of their earnings 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, “Quite a lot of occasions, well being care comes with a job.”

This assertion is partially correct. Most employees within the U.S. get well being protection by work. But it surely glosses over facets of our nation’s job-based medical health insurance system — reminiscent of how prices and protection, particularly for these with decrease incomes, could make an employer plan out of attain even whether it is out there.

Backside line: Not all jobs present medical health insurance or supply plans to all their employees. After they do, value and high quality range broadly — making Thune’s assertion an oversimplification.

We charge 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 Accountability Beneath the Reasonably priced 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 Price-Sharing for Households With Massive 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 Reasonably priced Care Act,” July 22, 2024.

Harvard Enterprise Overview, “Why Do Employers Present Well being Care within the First Place?” March 15, 2019.

Congressional Funds Workplace letter on the One Massive 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 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 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 Employees Allowance for Protection,” Oct. 2, 2024.

KFF Well being Information, “Trump’s ‘One Massive Lovely 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 applications at KFF—an unbiased supply of well being coverage analysis, polling, and journalism. Study extra about KFF.

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