Volatile Employment and Health Insurance Gaps Among Low- and Middle-Income Workers - Takeaways - MDSpire
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Employment Instability and Health Insurance Disparities Among Low- and Middle-Income Workers

  • By

  • Vineeth Amba

  • Renuka Tipirneni

  • John Z. Ayanian

  • Sumit Agarwal

  • September 15, 2026

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  • 1

    In 2023, 50% of low-income households reported unpredictable earnings, highlighting employment instability among low-income individuals.

  • 2

    Workers with income or work-hour volatility had significantly lower rates of employer-sponsored insurance offers compared to stable workers.

  • 3

    Medicaid coverage was more common among workers experiencing employment volatility, while ACA marketplace coverage was also higher for these groups.

  • 4

    House Resolution 1 will condition Medicaid eligibility on documented work hours, potentially increasing the risk of disenrollment for volatile workers.

  • 5

    The expiration of enhanced Advanced Premium Tax Credits may further limit affordable coverage options for low- and middle-income workers.

Original Source(s)

Volatile Employment and Health Insurance Gaps Among Low- and Middle-Income Workers

  • by Vineeth Amba, Renuka Tipirneni, John Z. Ayanian, Sumit Agarwal

  • September 15, 2026

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