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Expand chart
Data: Kaiser Family Foundation; Chart: Chris Canipe/Axios

After many years of steady decline, the proportion of people under 65 with employer health coverage has started to increase. About seven million more people gained employer coverage between 2013 and 2017 — nearly as many as the 10 million people who were covered through the Affordable Care Act's marketplace last year.

Why it matters: Since people with employer coverage are the largest insured group in the country, the next wave of health reform will be more politically successful if it resonates with their concerns.

  • That's why Kamala Harris' comment this week about doing away with private health insurance, as part of a Medicare for All plan, exposes the danger for Democrats if they don't convince people who like their private coverage that they have something better to offer.

The big picture: As the chart shows, the share of the non-elderly population with employer coverage fell between 1999 and 2010. But it’s actually been rising in recent years, especially between 2013 and 2017, the last year for which we have data from the National Health Interview Survey.

  • Both a stronger economy and the ACA’s individual and employer mandates are likely reasons for the increase.

By the numbers:

  • The increase means that 156 million people were covered by employer-based insurance in 2017.
  • That makes it by far the single largest form of coverage, followed by Medicaid at 74 million.

Between the lines: The size of this group is a reminder of the biggest challenge for Medicare for All: it can't be too disruptive of the health coverage people already have.

It's also worth remembering that the big problem for these 156 million people isn't getting to universal coverage — it’s their deductibles and drug prices and premiums and surprise medical bills. Whether they are Trump voters in Indiana or longtime Democrats in California, they are looking for help paying their medical bills, not big ideas they cannot connect to their everyday problems.

The bottom line: The 2020 presidential candidates would do well not to forget that the employer market is where the largest share of Americans are experiencing problems with health care costs. And as debate about Medicare for All heats up, advocates will have to deal with the love-hate relationship 156 million workers have with their employer-based coverage.

Go deeper

Updated 50 mins ago - Politics & Policy

British national named in Colleyville synagogue standoff

A law enforcement vehicle sits near the Congregation Beth Israel synagogue on Jan. 16. Photo: Brandon Bell/Getty Images

British national Malik Faisal Akram took four people hostage at a Texas synagogue outside Fort Worth on Saturday, the FBI said in a statement.

State of play: Authorities had initially declined to release the name of the 44-year-old suspect or identify the hostages, all adults, though police chief Michael Miller confirmed that one of those held was Rabbi Charlie Cytron-Walker, who leads the congregation.

Updated 1 hour ago - Politics & Policy

Omicron dashboard

Illustration: Brendan Lynch/Axios

  1. Health: Concerns grow over CDC's isolation guidelines — Experts warn of more COVID-19 variants after Omicron — WHO recommends 2 new treatments — What "mild" really means when it comes to Omicron — Deaths are climbing as cases skyrocket.
  2. Vaccines: America's vaccination drive runs out of gas— Puerto Rico expands booster shot requirements— Supreme Court blocks Biden's vaccine mandate for large employers.
  3. Politics: Vivek Murthy calls SCOTUS vaccine mandate block "a setback for public health" — Focus group says Biden weak on COVID response, strong on democracy
  4. Economy: America's labor shortage is bigger than the pandemic— — CDC COVID guidance for cruise ships to be optional starting Saturday — The cost of testing.
  5. States: West Virginia governor feeling "extremely unwell" after positive test — Youngkin ends mandates for masks in schools and COVID vaccinations for state workers — America struggles to keep schools open
  6. World: Beijing reports first local Omicron case weeks before Winter Olympics — Teachers in France stage mass walkout over COVID protocols.
  7. Variant tracker
6 hours ago - Sports

Novak Djokovic loses Australian visa appeal

Novak Djokovic of Serbia plays a forehand during a practice session ahead of the 2022 Australian Open at Melbourne Park on January 14, 2022. Photo: Daniel Pockett/Getty Images

Tennis star Novak Djokovic left Australia on Sunday evening, facing a three-year visa ban after an appeals court in the country revoked his visa.

Driving the news: Djokovic will not be able to defend his Australian Open title when the tournament starts in Melbourne. The World No. 1 is looking to break a three-way tie with Roger Federer and Rafael Nadal for most Grand Slam men's singles titles.

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