Employer-sponsored insurance research often doesn’t account for varying incomes. 

Although there has been a lot of research on the Employer-Sponsored Insurance (ESI) population, much of it pools individuals with different incomes into the same group. This approach masks important differences in health care spending between groups. Most ESI plans currently provide equal coverage for all workers within a firm, regardless of salary, which can lead to some workers being “underinsured.” For individuals with limited incomes, the budgetary burden of unaffordable health care costs can force tradeoffs between health care and other essential needs.

The Commonwealth Fund realized that more research was needed on granular patterns of health care expenditures of ESI enrollees by income—especially the financial strain faced by those in certain income brackets—to better understand the financial landscape.  

NORC mined national survey data to study ESI health care burdens by income.

NORC used nationally representative data from the Survey of Income and Program Participation to examine the health care spending burden on ESI enrollees of varying incomes. We descriptively examined the share of household income spent on health care (premiums and out of pocket expenses) and also looked at the extent to which individuals were affected by varying degrees of (prespecified) spending burden.