Approximately 24% of U.S. employees are currently staying in unwanted jobs primarily to maintain their health insurance coverage, according to a new report from the West Health-Gallup Center on Healthcare in America. This figure, representing roughly 23 million adults, marks a substantial increase from 16% recorded in 2021, signaling a growing phenomenon of ‘job lock’ with concerning implications for the nation’s economy.
The study, released Wednesday, highlights that this reluctance to change employment due to healthcare concerns is particularly acute among individuals managing chronic health conditions. For working adults with three or more such conditions, the prevalence of job lock surges to 41%, underscoring the critical role employer-sponsored health benefits play in their financial and medical stability.
Rising Costs Fueling Job Lock
The increasing grip of job lock coincides with heightened anxieties over healthcare affordability. An April poll conducted by the health research organization KFF found that nearly two-thirds of adults are concerned about their ability to afford healthcare, a worry that tied with concerns about gas and transportation costs as the top economic stressor. Larry Levitt, executive vice president for health policy at KFF, who was not involved in the West Health-Gallup study, notes that these findings align with KFF’s own research, stating, ‘Healthcare tops the list of economic worries right now. So it stands to reason that people would be concerned about leaving an unwanted job for fear of losing their health insurance.’
Ellyn Maese, a research director for the West Health-Gallup Center, emphasizes the severity of the trend. ‘Anybody having to stay in a job just to keep their health insurance, knowing that they want to leave, is crazy,’ Maese states. ‘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.’
Economic Repercussions and Policy Debates
Beyond individual discontent, the widespread nature of job lock poses broader economic challenges. Maese explains that unhappy employees are less effective, which negatively impacts the U.S. economy. ‘Leaving, moving, becoming entrepreneurs,’ she argues, is ‘what we need to see for our economy to really thrive.’
Pessimism about the job market may further compound the issue. A May Gallup poll indicated that only 28% of U.S. workers believed it was a good time to find a job, the lowest sentiment recorded since 2013. This lack of confidence could deter individuals from seeking new opportunities, even if they are dissatisfied with their current roles.
Recent policy changes related to the Affordable Care Act (ACA) are also cited as a contributing factor. In 2021, Congress temporarily expanded financial assistance for middle-income individuals purchasing insurance through ACA marketplaces. However, these subsidies were allowed to expire in 2025, leading to increased costs for many and, according to Levitt, exacerbating the job lock phenomenon. Maese specifically highlights the plight of the middle class, who are ‘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.’
The need for reform is a point of consensus among experts, though their proposed solutions diverge. Maese advocates for policy adjustments such as reinstating ACA subsidies to ‘course correct.’ Conversely, Michael Cannon, director of health policy studies at the Cato Institute, a libertarian think tank, while acknowledging that ‘everyone acknowledges that job lock is real,’ criticizes the current system for ‘favoring employer-sponsored health insurance’ which ‘creates coverage gaps, reduces income mobility, and is crying out for reform.’ Cannon champions an efficient free market approach, advocating for insurance coverage that belongs to individuals rather than their jobs, allowing consumers to control their healthcare dollars and choose their own plans, including expanding Health Savings Account (HSA) options.
Despite their differing ideological stances, both Maese and Cannon agree on the urgent need for systemic change. Cannon succinctly summarizes the historical context: ‘For 100 years, Congress has effectively penalized workers unless they enroll in health insurance that disappears when your job does.’ The latest West Health-Gallup findings underscore that this long-standing issue continues to constrain millions of American workers, stifling economic dynamism and individual career aspirations.
