Arielle Zionts
“A lot of times, health care comes with a job.”
Sen. John Thune (R-S.D.), in an interview with KOTA on May 30, 2025
Millions of individuals are expected to lose entry to Medicaid and Affordable Care Act market medical insurance plans if federal lawmakers approve the One Big Beautiful Bill Act, President Donald Trump’s home coverage package deal, which is now shifting by means of the Senate.
Senate Majority Leader John Thune mentioned well being care and the pending laws in an interview with KOTA, a South Dakota TV station. But he targeted on a special form of medical insurance — employer-sponsored insurance coverage.
“A lot of times, health care comes with a job,” Thune stated.
Thune’s feedback within the interview had been made within the context of highlighting a part of the GOP’s financial coverage goal. “Creating those better-paying jobs that come with benefits is ultimately the goal here,” he stated.
KFF Health News reached out to Thune’s workplace to seek 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 lead a worker to acquiring health care.”
Paul Fronstin, director of well being advantages analysis on the Employee Benefit Research Institute, stated Thune’s remark can also be alluding to discussions surrounding Medicaid work necessities. The One Big Beautiful Bill Act would let nondisabled adults enroll in Medicaid provided that they show they’re volunteering, working, or looking or coaching for work.
Medicaid, funded by the federal authorities and states, is the nation’s major 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.), for example, told CNBC the invoice isn’t about “kicking people off Medicaid. It’s transitioning from Medicaid to employer-provided health care.”
But 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 Health Insurance: The Basics
These consultants stated most jobs do supply medical insurance. But additionally they stated the hyperlink between employment and work-based protection shouldn’t be at all times simple.
“When I see this statement, I’m like, ‘I’ve got so much more to say about this.’ But I’m not arguing with the statement,” Fronstin stated.
Matthew Rae, an affiliate director targeted on researching personal insurance coverage at KFF, a well being data nonprofit that features KFF Health News, additionally weighed in.
“Employer-sponsored coverage remains the bedrock of how people get health insurance in the United States,” Rae stated. “I would say that getting a job is not a guarantee you’re going to have health insurance. It just increases your chances of getting it.”
About 60% of Americans 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, according to 2023 KFF data.
Among employees ages 18 to 64 who had been eligible however didn’t join their office insurance coverage, 28% stated the explanation they determined to not enroll was that the plans had been too costly, 2023 KFF data confirmed.
Most of those employees discovered medical insurance elsewhere, equivalent to by means of a relative’s office plan. But a small share of eligible workers, 3.7%, were uninsured.
Health insurance coverage has been “the most valued benefit in the workplace” since companies began offering it to recruit workers in a good labor market throughout World War II, Fronstin stated.
Federal legislation additionally encourages firms to supply plans. Under the Affordable Care Act, employers with 50 or extra full-time employees are penalized in the event that they don’t supply most workers insurance coverage that the federal authorities considers reasonably priced.
As of final yr, 54% of firms supplied medical insurance to no less than some workers, according to KFF.
But that’s not the principle method the ACA helped lower the rate of individuals with out medical insurance, stated Melissa Thomasson, a professor at Miami University in Ohio who specializes within the financial historical past of medical insurance. “Nearly all of that” change, she stated, got here from the ACA creating personal market plans and permitting states to broaden Medicaid eligibility.
Health policy analysts say the One Big Beautiful Bill would make it tougher for folks to qualify or afford market plans, with proposals that may improve paperwork, shorten enrollment durations, and permit enhanced tax credit to fizzle out. Thomasson additionally famous that political rhetoric surrounding jobs and medical insurance doesn’t at all times align.
“We often talk about small businesses being the engine of job creation,” however these are the companies that always can’t afford to supply office insurance coverage, she stated.
So Who Isn’t Insured Through Workplace Insurance?
The most blatant 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 trying to find work, individuals who select to not work, and people who can’t work, due to a incapacity or sickness.
Another 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 accordance with 2023 data from KFF.
Some of those folks work for firms that don’t supply medical insurance. These employers are usually small companies or a part of sure industries, equivalent to farming and development.
Others are part-time, short-term, or seasonal employees at firms that supply medical insurance solely to full-time workers. Workers with low incomes are considerably much less possible than these with increased incomes to be eligible for office insurance coverage, according to 2023 KFF data.
People 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.
Cost and Quality — And Therefore Access to Care — Vary
Just as a result of somebody has medical insurance doesn’t imply they’ll get the well being care they want. People could skip or delay care if their plans are unaffordable or in the event that they restrict in-network suppliers.
“Health benefits come in all shapes and sizes,” Fronstin stated. “Some employers offer very generous benefits, and others less so.”
KFF information reveals that premiums and enrollees’ cost-sharing bills grew sooner than wages from 2008 to 2018 however have slowed in recent years.
Whether office insurance coverage is reasonably priced considerably varies by revenue. According to 2020 KFF data, 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 stated, “A lot of times, health care comes with a job.”
This assertion is partially correct. Most employees within the U.S. get well being protection by means of work. But it glosses over points of our nation’s job-based medical insurance system — equivalent to how prices and protection, particularly for these with decrease incomes, could make an employer plan out of attain even whether it is obtainable.
Bottom line: Not all jobs present medical insurance or supply plans to all their employees. When they do, value and high quality range broadly — making Thune’s assertion an oversimplification.
We fee this assertion Half True.
Sources
KOTA interview with Sen. John Thune, May 30, 2025.
CNBC interview with Sen. James Lankford, June 5, 2025.
KFF, “2024 Employer Health Benefits Survey,” Oct. 9, 2024.
KFF, “Employer Responsibility Under the Affordable Care Act,” Feb. 29, 2024.
KFF, “Employer-Sponsored Health Insurance 101,” May 28, 2024.
Peterson-KFF Health System Tracker, “What Are the Recent Trends in Employer-Based Health Coverage?” Dec. 22, 2023.
Peterson-KFF Health System Tracker, “How Affordability of Employer Coverage Varies by Family Income,”March 10, 2022.
Peterson-KFF Health System Tracker, “Tracking the Rise in Premium Contributions and Cost-Sharing for Families With Large Employer Coverage,” Aug. 14, 2019.
Manhattan Institute, “Put Employees in Control of Health Insurance with ‘Worker’s Choice ICHRA,’” May 22, 2025.
Brookings, “Uninsurance Rates Have Fallen Significantly Following the Affordable Care Act,” July 22, 2024.
Harvard Business Review, “Why Do Employers Provide Health Care in the First Place?” March 15, 2019.
Congressional Budget Office letter on the One Big Beautiful Bill Act growing the variety of uninsured folks, June 4, 2025.
Phone interview with Paul Fronstin, director of well being advantages analysis on the Employee Benefit Research Institute and a member of the Commonwealth Fund’s National Task Force on the Future Role of Employers within the U.S. Health System, June 6, 2025.
Phone interview with Melissa Thomasson, professor and well being economist at Miami University, June 6, 2025.
Phone interview with Maanasa Kona, affiliate analysis professor on the Center on Health Insurance Reforms at Georgetown University, June 6, 2025.
Phone interview with Matthew Rae, affiliate director for the Health Care Marketplace Program at KFF, June 10, 2025.
Phone interview with Sally Pipes, president and CEO of the Pacific Research Institute, June 11, 2025.
Email correspondence with Ryan Wrasse, communications director for Sen. John Thune, June 10, 2025.
KFF Health News, “Some Employers Test Arrangement To Give Workers Allowance for Coverage,” Oct. 2, 2024.
KFF Health News, “Trump’s ‘One Big Beautiful Bill’ Continues Assault on Obamacare,” June 3, 2025.
KFF Health News is a nationwide newsroom that produces in-depth journalism about well being points and is among the core working applications at KFF—an unbiased supply of well being coverage analysis, polling, and journalism. Learn extra about KFF.
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