Nearly 23 million American workers remain in jobs they want to leave because they cannot afford to lose their employer-sponsored health coverage, according to figures gathered by the West Health-Gallup Center on Healthcare in America. The share of workers reporting job lock - staying in a job to preserve health insurance - has risen to 24 percent, up eight percentage points from 16 percent in 2021.
The study surveyed 5,660 US adults between October 27 and December 22, 2025, using the Gallup Panel, a probability-based nationally representative sample. The analysis focused on 2,322 respondents who were employed and relied on employer-sponsored insurance as their primary coverage source.
The figures arrive alongside sustained premium growth. The Kaiser Family Foundation (KFF) 2025 Employer Health Benefits Survey found the average annual premium for family coverage reached $26,993 in 2025, up 6 percent year-over-year. Workers contributed an average of $6,850 of that cost from their paychecks. KFF recorded this as the third consecutive year of gains at or above that level.
According to West Health-Gallup, half of Americans now report difficulty consistently paying for needed medical care or prescriptions, the backdrop against which the job lock figures should be read.
The West Health-Gallup data show a consistent pattern across financial hardship measures. Workers who carry household medical debt report job lock at 44 percent, more than double the rate of those without (21 percent). Workers who borrowed money to cover medical care in the past year report a rate of 37 percent, against 22 percent for those who had not borrowed.
The numbers climb at the extremes of financial pressure. Among workers who describe healthcare costs as a "major financial burden," 48 percent report staying in their current job for coverage. Among those who say healthcare costs contribute "a lot of stress" to their daily lives, the rate reaches 53 percent.
The income breakdown points to a specific vulnerability in the middle of the earnings distribution. Job lock peaks at 27 percent among households earning between $48,000 and $90,000 a year, then falls to 16 percent among those earning over $180,000. Workers in that band typically earn too much to qualify for Affordable Care Act (ACA) marketplace subsidies after leaving a job, but not enough to absorb individual market premiums without an employer contribution.
Workers with chronic conditions face markedly higher rates of job lock. Among those with one or more chronic conditions beyond high blood pressure or high cholesterol, 29 percent report job lock, against 17 percent for those without such diagnoses. Among workers managing three or more chronic conditions, the rate rises to 41 percent.
Specific conditions show pronounced effects. Workers with immune-compromising conditions report a rate of 36 percent. Among those with depression, the rate is 35 percent.
Women are more likely than men to report staying in an unwanted job for coverage, at 30 percent against 20 percent. Women in the study also carried medical debt at nearly double the rate of men at 22 percent versus 12 percent. Women were more likely to report healthcare costs as a source of financial stress at 56 percent versus 44 percent.
The researchers say those compounding pressures likely contribute to the gender difference in job lock rates.
Workers with chronic conditions and medical debt are overrepresented among the job-locked, and are most likely to generate above-average claims. A plan design that holds workers in place through financial pressure concentrates higher-cost members within the workforce over time, which feeds directly into claims trends and future renewal pricing.
The West Health-Gallup findings sit alongside employer-side data pointing in the same direction. Lockton's 2026 National Benefits Survey, drawing on 1,705 plan sponsors, found 54 percent of employers now rank cost reduction as their top benefits priority, up from 38 percent in 2025. Talent attraction and retention fell behind cost as the primary stated driver for the first time in years.
Plan design decisions that shift more cost to workers affect more than satisfaction scores. Higher deductibles, narrower networks, and reduced employer contributions all affect whether workers can realistically consider leaving their current employer. They also determine who stays in the workforce as a result.
The West Health-Gallup report cites academic research linking job lock to reduced labor mobility and lower rates of entrepreneurship. A 2026 study in the American Journal of Preventive Medicine found elevated occupational injury rates among job-locked older workers, based on the Health and Retirement Study dataset from 2010 to 2022.
