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On the Edge: Low-Wage Workers and Their Health Insurance Coverage

In terms of access to health care, workers who earn low wages are among the most vulnerable members of the American labor force. Of the 31 million workers in the United States who either work for businesses that do not offer health insurance or are not eligible for the company health plan, more than half earn less than $10 an hour. Although employees of small companies are particularly unlikely to have coverage through their jobs, low-wage workers in firms of all sizes are disadvantaged compared with their higher-wage colleagues. Even when low-income workers do have health insurance, they often have difficulty paying their share of costs.

This brief uses the Commonwealth Fund 2001 Health Insurance Survey to assess the relative health insurance experiences of workers across the country by the wages they earn and the size of the company in which they work. Overall, the survey reveals that workers who earn low wages— even those in large firms—run the highest risk of being uninsured. Moreover, when low-wage workers do have health insurance, they are more likely than higher-wage workers to spend a large share of their income on premiums. Lack of coverage and low income combine to make access to the health care system difficult and create severe financial stress for low-wage workers and their families.

Publication Details



On the Edge: Low-Wage Workers and Their Health Insurance Coverage, Sara R. Collins, Ph.D., Cathy Schoen, Ph.D., Diane Colasanto et al., The Commonwealth Fund, March 2003