A new study from the West Health-Gallup Center on American Health Care finds that “job lock” is even more common among people with chronic illnesses, 41% of whom report staying in a job to maintain health insurance. Creative Images Lab/Getty Images hide title toggle title Creative Images Lab/Getty Images Why do some people stay in
A new study from the West Health-Gallup Center on American Health Care finds that “job lock” is even more common among people with chronic illnesses, 41% of whom report staying in a job to maintain health insurance.
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Why do some people stay in terrible, horrible, no good, or very bad jobs?
A new report finds that nearly a quarter of workers who obtain health insurance through their job report staying in undesirable jobs to obtain health insurance, a figure that has increased dramatically over the past five years.
The West Health-Gallup Center on American Health Care survey finds that approximately 23 million adults are in what the report’s authors call “job lock.” In 2021, 16% of those surveyed were in a situation of work blockade.
“Anyone who has to stay at a job just to keep their health insurance, knowing they want to quit, is crazy,” says Ellyn Maese, research director at the center, a partnership between Gallup and West Health. “It’s a worrying number, even if it’s 10%. But when we see it increase to 1 in 4 employees, it’s pretty serious.”
The numbers are higher for people who are sick. Of working adults with three or more chronic health conditions, the report found that 41% stayed in their jobs to obtain health insurance.
This comes at a time when concerns about healthcare costs have been rising. An April survey from the health research organization KFF found that nearly two-thirds of adults are anxious about being able to afford health care, tied for first place with concerns about the price of gas and transportation.
“Health care is at the top of the list of economic concerns right now,” says Larry Levitt, executive vice president of health policy at KFF. “So it stands to reason that people would be worried about leaving an unwanted job for fear of losing their health insurance.”
Levitt was not involved in the new West Health-Gallup study and says it fits the picture KFF polls have found.
The results of the survey released Wednesday may be compounded by pessimism about the labor market, Maese says. A May Gallup poll found that only 28% of American workers said it’s a good time to find a job, the lowest level since 2013.
The economic effects
The consequences can go beyond employee discontent.
Disgruntled employees are less effective, Maese explains, and that’s bad for the U.S. economy overall. “Leaving, moving and becoming entrepreneurs,” he says, “is what we need for our economy to really thrive.”
To that end, recent changes to the Affordable Care Act may have been unhelpful. In 2021, Congress increased financial assistance for middle-income people who purchase their own insurance through the ACA marketplaces. When Congress allowed these subsidies to expire in 2025, that help for would-be entrepreneurs evaporated. Levitt says the expiration of ACA subsidies has contributed to rising costs and trapped American workers in jobs they might otherwise give up.
Michael Cannon, director of health policy studies at the Cato Institute, a libertarian think tank, agrees this is a problem.
“Everyone recognizes that the labor blockade is real,” he says.
“Whether the degree of job lock is 8%, 24%, or anything else,” Cannon says, “favoring employer-sponsored health insurance creates coverage gaps, reduces income mobility, and cries out for reform.”
Cannon would prefer insurance coverage that belongs to individuals rather than their jobs: insurance purchased by consumers that would be stable as they change jobs.
Maese is especially concerned about the middle class: workers who are “stuck in the middle, where they don’t really qualify for assistance,” she says, “but also don’t earn enough to be able to cover the rising costs of health care.”
To correct course, a policy change is needed, such as bringing back ACA subsidies, Maese says.
On the other hand, Cannon has long been a vocal critic of the ACA. He advocates for an efficient free-market option that would “allow consumers to control their health insurance dollars and choose their own health plan.” He favors expanding HSA options.
However, both Master and Cannon They agree that reform is needed.
“For 100 years,” Cannon says, “Congress has effectively penalized workers unless they sign up for health insurance that disappears when their job disappears.”
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