1 in 4 Americans Stay in Jobs for Health Insurance

Nearly one in four U.S. workers — approximately 23 million adults — are staying in jobs they would otherwise leave specifically to keep their health insurance, according to a new Gallup survey conducted in partnership with West Health. The phenomenon, known as “job lock,” has risen sharply from 16% in 2021, an eight-percentage-point increase that underscores the deepening link between employment and healthcare access in the United States.

The nationally representative survey, conducted from October 27 to December 22, 2025, polled 5,660 U.S. adults and focused on 2,322 employed respondents who rely on employer-sponsored health insurance. The findings come at a time when healthcare affordability concerns are at their highest level in five years.

Who Is Most Affected

The burden of job lock falls disproportionately on specific groups. Women are significantly more likely than men to report staying in unwanted jobs for health insurance — 30% compared with 20%. The gap reflects broader financial pressures: women are more likely to report medical debt (22% vs. 12%) and multiple chronic conditions (66% vs. 57%).

Workers with chronic health conditions face particularly acute challenges. Among those with three or more chronic conditions, 41% report job lock, compared with just 17% of those without chronic conditions. The pattern is especially pronounced for individuals with asthma (29%), immune-compromising conditions (36%), depression (35%), and anxiety (33%).

Financial strain amplifies the problem dramatically. Among workers carrying medical debt, 44% report job lock — more than double the rate of those without debt (21%). Nearly half (48%) of those who describe healthcare expenses as a “major financial burden” say they are staying in a job to maintain coverage, while 53% of those experiencing “a lot of stress” from healthcare costs report the same.

Job lock peaks at 27% among households earning $48,000 to $90,000 annually — the middle-income bracket that often earns too much for substantial subsidies but not enough to comfortably absorb rising healthcare costs.

A Worsening Trend

The rise in job lock coincides with significant shifts in the healthcare landscape. Enhanced premium subsidies under the Affordable Care Act, enacted as part of pandemic relief in 2021, expired at the end of 2025. The result was stark: ACA marketplace enrollment fell by 2.6 million people (12%) from February 2025 to February 2026 — the steepest single-year drop since the marketplaces opened in 2014. For those who kept their plans, the average subsidized enrollee’s cost jumped approximately 114%.

Meanwhile, a May 2026 Gallup poll found that only 28% of U.S. workers said it was a good time to find a job — the lowest reading since 2013. This combination of a tight labor market and soaring healthcare costs has trapped many workers in positions they would otherwise leave.

Expert Perspectives

“Anybody having to stay in a job just to keep their health insurance, knowing that they want to leave, is crazy,” said Ellyn Maese, research director at the West Health-Gallup Center on Healthcare in America. “That is a concerning figure, even if it’s 10%. But when we’re seeing it rise to 1 in 4 employees, that’s pretty serious.”

Larry Levitt, executive vice president for health policy at KFF, noted that “healthcare tops the list of economic worries right now. So it stands to reason that people would be concerned about leaving an unwanted job for fear of losing their health insurance.”

Michael Cannon, director of health policy studies at the Cato Institute, offered a more structural critique: “For 100 years, Congress has effectively penalized workers unless they enroll in health insurance that disappears when your job does.”

Economic Implications

Job lock carries significant economic consequences beyond individual dissatisfaction. Workers who remain in ill-fitting jobs are less productive, and the phenomenon suppresses labor mobility, entrepreneurship, and wage growth.

“Leaving, moving, becoming entrepreneurs — that is what we need to see for our economy to really thrive,” Maese said.

The Policy Divide

The findings add urgency to an ongoing policy debate. One camp, represented by Maese and Levitt, advocates restoring the enhanced ACA subsidies to make non-employer coverage more affordable. Cannon and other market-oriented reformers argue for a more fundamental shift — moving away from employer-sponsored insurance entirely toward individually owned plans, expanded Health Savings Accounts, and greater free-market competition.

Despite their differences, both sides agree that the current system is failing. With nearly a quarter of American workers now reporting job lock — and healthcare costs continuing to rise faster than wages — the pressure for reform is likely to intensify.

What to Watch

Whether Congress will restore the enhanced ACA subsidies remains an open question. With the next enrollment period approaching and insurers proposing an average premium increase of 14% for 2027, the affordability crisis shows no signs of abating. For the 23 million Americans currently locked into jobs by their health insurance, the stakes could not be higher.