New research shows a rising number of workers are stuck, and it's largely going unnoticed
Almost a quarter of American workers who get health insurance through their employer say they're staying in a job they'd otherwise leave, just to keep their coverage. That's according to a new survey from the West Health-Gallup Center on Healthcare in America, which found that this phenomenon, known as job lock, has climbed to 24%, up from 16% in 2021. For workers with three or more chronic health conditions, the number jumps to 41%.
Ellyn Maese, senior research consultant at Gallup in Washington, D.C., said the increase reflects three trends converging at once.
"It's that healthcare is becoming more difficult to afford at the same time when there's a lot of uncertainty about other options outside of employer sponsored insurance," she said. "I'm talking especially about the Affordable Care Act and subsidy kind of shake ups there, and then just confidence around being able to actually find a job."
West Health and Gallup have tracked healthcare affordability for five years, and Maese said the latest numbers are the worst yet. Rising premiums, high deductible plan switches, and growing out-of-pocket costs have made workers more dependent on the coverage their job provides. In fact, just three in 10 Americans currently say it's a good time to find a job, according to Gallup polling, down from seven in 10 in 2022.
Why this matters beyond the individual worker
Job lock doesn't just affect the person who feels stuck. Maese pointed to years of Gallup research on disengagement to explain why employers should pay attention to this data.
"When people are forced to keep a job that they don't want to be in, whether it's to keep their insurance or for any other reason, we see their engagement as an employee tank," she said. "Their productivity isn't there. They're more likely to have safety issues or security issues when it comes to their job. They're more likely to miss days of work."
That drop in engagement carries a real cost. Gallup's own State of the Global Workplace research has tied falling engagement to trillions in lost productivity worldwide, and Maese said job lock follows a similar pattern.
"Organizations that are employing people who are disengaged, their bottom line goes down because they don't have that employee productivity," she said. "Their cost of turnover goes way up because they're losing people."
There's a broader economic cost too, Maese said, when workers can't move freely into roles that fit their skills.
"We want people leveling up or becoming entrepreneurs," she said. "That's good for the labor market. It creates competitiveness around labor and helps to make sure that the labor we have is doing the most to contribute to the country. And when people are stuck, we're losing the benefit of all of that."
A blind spot for most organizations
Job lock rarely shows up as a clear, named problem in company data.
"I think a lot of this is flying under the radar," Maese said. "But the organizations that are already thinking about things like monitoring employee well being and engagement are probably the most likely to catch it."
She said the signal tends to surface indirectly, through the same tools organizations already use to track employee sentiment and engagement, particularly through relationships with supervisors and managers, rather than through any dedicated job lock metric.
The survey didn't break results down by industry or company size, but one pattern stood out to researchers. Women reported staying in unwanted jobs to keep their health benefits at notably higher rates than men.
"There's a lot of pressures on women just to kind of stay in jobs," Maese said. "When you think about slower, lower wage growth coupled with higher health burden and health expenses that usually exceed that of men, I think women are probably especially kind of vulnerable to this pattern."
Separate research on healthcare cost disparities from Deloitte found employed women in the U.S. pay billions more out of pocket for healthcare annually than employed men, even excluding pregnancy-related costs. Maese said women probably need more attention when it comes to strategies for developing and retaining employees more broadly.
What employers can actually do
Better benefits alone won't fix job lock, Maese said, and that shouldn't be the goal in the first place.
"I think the first and foremost thing is creating an engaging workplace where people want to work, so that they're not just staying there because of the benefits," she said. "If the best thing about your organization is the benefits package, you've got such bigger problems."
Still, she said benefits packages deserve more attention than most organizations give them, including confirming that plans genuinely serve employees' interests, offer solid mental health coverage, and are easy to understand and use.
"If this is something that's so important to people that they would suffer through a bad job, it should also be a benefit in a good job," Maese said. "It should be something that helps employees see that their company cares about them as a person."
She said that kind of investment can say more to employees than words alone.
"I think a lot of leaders just say we care about the person," Maese said. "But when leaders are willing to invest in strong benefits packages, it really creates a meaningful impact on employees, and they're more likely to believe in it."
One finding surprised Gallup's own researchers. Job lock isn't concentrated among lower income workers, as the team initially expected.
"What we're seeing is that it's problematic, especially among our middle class," Maese said.
Employers can't assume a good paycheck is enough on its own, she added, since even middle class families are struggling with healthcare affordability right now.
That struggle has only intensified as rising costs in the Affordable Care Act marketplace squeeze households across income levels.
"We have to think about how this is affecting employees across America," she said, "and not thinking of this as a low income problem or a low ed problem or something like that."
