[Excerpt] A ground-breaking new study by The Commonwealth Fund, The Growing Share of Uninsured Workers Employed by Large Firms, sheds important light on a previously unexplored dimension of the health care crisis —the decline in coverage and rising uninsured rates among employees of large firms. According to the study, a surprising percentage of uninsured individuals — more than one in four — works for or has family members who work for large firms. In addition, the share of uninsured workers employed by large, private-sector firms rose substantially between 1987 and 2001, from 25 percent of all uninsured workers to 32 percent, and the share of large-firm employees with health coverage through their jobs fell from 71 percent to 66 percent.
The phenomenon described in The Commonwealth Fund study is not simply or even largely because large employers are not providing any coverage. More to the point, some large employers maintain health plans so laden with restrictions and so costly to employees that few workers end up with coverage under the plans. As a recent Wall Street Journal feature article suggests, Wal-Mart leads the pack among such large employers that fail to provide adequate and affordable health coverage for their employees.