Report: Even with a job, insurance is no longer a sure thing

— -- Employer-based health insurance is quickly becoming a thing of the past for millions of American workers, a new report says.

Workers are losing jobs that offer health insurance and getting part-time or contract jobs that make finding affordable coverage more difficult, researchers say in a report released Wednesday by the nonprofit Iowa Policy Project.

"Employer-provided health insurance has become more rare and more expensive, leaving the economically weakest workers to fend for themselves," said Noga O'Connor, co-author of the report, which was funded by the U.S. Department of Labor.

The report says "nonstandard" workers -- ones with part-time, freelance, contract or temporary jobs -- are "significantly less likely than standard workers to have health insurance at all," O'Connor said.

The census does not collect specific information on the numbers of nonstandard workers, O'Connor said, but the Iowa Policy Project's best estimate is that 40% of the U.S. work force was by 2009 in a job that isn't full-time or doesn't provide health insurance. That's compared with 27% -- another estimate patched together using imprecise census categories -- four years earlier, said O'Connor.

She believes the census should collect better information about the types of jobs workers have. "This should be looked at in greater detail, because it's a really big deal," O'Connor said.

Iowa Policy Project reports in 2005 and 2006 showed workers in nonstandard jobs tend not to have job-based insurance or retirement plans. The newest report, "Fending for Themselves," follows a December 2010 study that illustrated problems faced by consumers in the discount medical plan industry. Besides O'Connor and co-author Andrew Cannon, IPP Research Director Peter Fisher and Senior Research Consultant Colin Gordon helped write the report.

The latest research included a survey that shows confusion among consumers about their own health coverage, leading researchers to conclude insurance coverage may be over-reported in census data. As in the 2005 report, IPP researchers found some people identify themselves as having insurance but do not -- only possessing a discount card that is not insurance. IPP found similar results in 2010, when 9% of those surveyed said they have a discount medical plan, but almost half of those considered it to be insurance.

"Our survey found that while 82% of our employed respondents claimed to have some health insurance, some had only a medical discount plan, reducing the real coverage rate shown by our survey to 78%," the researchers said in a summary.

Despite increased scrutiny, the discount medical plan industry has serious gaps in regulation and uniformity of benefits to consumers, the report says.

The study was one of two produced by IPP and fully funded by the U.S. Department of Labor.