Nearly 1 in 4 U.S. workers stay in unwanted jobs for health insurance

Chronic illness intensifies job lock, survey finds

The survey, released Wednesday by the West Health-Gallup Center on Healthcare in America, found that 24% of workers who receive health insurance through their employer reported staying in jobs they would otherwise leave, compared with 16% in the 2021 survey. The study estimates that the pattern — which researchers call “job lock” — affects about 23 million U.S. adults.

The share was even higher for workers with health problems. Among respondents with three or more chronic health conditions, 41% said they remained in their jobs to keep health insurance, according to the report.

Ellyn Maese, a research director at the center, said the trend is a significant concern. “Anybody having to stay in a job just to keep their health insurance, knowing that they want to leave, is crazy,” Maese told NPR. “That is a concerning figure, even if it’s 10%. But when we’re seeing it rise to 1 in 4 employees, that’s pretty serious.”

An April poll from the health research organization KFF found nearly two-thirds of adults are worried about affording healthcare, tied for first with concerns about affording gas and transportation.

Larry Levitt, executive vice president for health policy at KFF, said the survey fits with what his organization has been tracking. “Healthcare tops the list of economic worries right now,” Levitt said, speaking as an expert not involved in the West Health-Gallup study. “So it stands to reason that people would be concerned about leaving an unwanted job for fear of losing their health insurance.”

The enhanced subsidies Congress added to the Affordable Care Act marketplaces in 2021 expired in 2025, pushing up premiums for people buying their own coverage. Levitt said the expiration has contributed to rising costs and made it harder for workers to leave jobs they might otherwise quit.

The Cato Institute’s Michael Cannon, a longtime ACA critic who agreed with the study’s findings about job lock, said the problem extends beyond the subsidy expiration. “Everyone acknowledges that job lock is real,” Cannon said. “Whether the extent of job lock is 8%, 24%, or something else, favoring employer-sponsored health insurance creates coverage gaps, reduces income mobility, and is crying out for reform.”

Cannon said he would prefer a system in which insurance belongs to individuals rather than employers, allowing workers to keep their coverage when they change jobs. He supports expanding health savings account options.

Maese said she is especially concerned about middle-class workers who do not qualify for subsidies but cannot keep up with rising healthcare costs. “Stuck in the middle, where they don’t really qualify for assistance, but they also don’t make enough to be able to catch up with the rising costs of healthcare,” she said.

Worries about finding a new job may be compounding the problem. A Gallup poll in May found that just 28% of U.S. workers said it is a good time to find a job, the lowest optimism reading since 2013.

Despite their different policy prescriptions for the ACA, both Maese and Cannon said the current system needs reform. “For 100 years,” Cannon said, “Congress has effectively penalized workers unless they enroll in health insurance that disappears when your job does.”