Health insurance costs keep millions of American workers tied to unwanted jobs

Mounting healthcare bills and debt are forcing employees to stay in positions they would rather leave, according to new research tracking employer benefits across the United States.

When an employee decides whether to leave a position, the choice traditionally turns on pay, working conditions, career advancement, and personal satisfaction. In a market where medical coverage is tied directly to an employer, another factor can quietly override all of them. An employee who leaves a job risks losing access to affordable medical care, interrupting treatments, or exposing a household to catastrophic out-of-pocket bills. When healthcare expenses rise across the broader economy, the threat of losing coverage grows severe enough that workers stay in jobs they want to leave simply to keep their health plans.

Economists and public health researchers refer to this phenomenon as job lock, a dynamic in which the necessity of retaining employer-sponsored health insurance prevents workers from seeking better opportunities, starting new businesses, or leaving toxic work environments. The friction affects individual careers and shapes the wider economy, reducing mobility and keeping people in positions where their skills and aspirations may be poorly matched. A clear chain of incentives drives the trap. Medical treatment requires continuous financing, and employer policies provide the primary conduit for that financing for most working adults. When household savings are thin or medical debts accumulate, any break in coverage threatens personal finances. The fear of an uncovered illness forces the employee to stay put, trading workplace satisfaction for institutional protection.

A nationwide investigation by the West Health-Gallup Center on Healthcare in America reveals that this form of dependency has expanded substantially across the United States workforce.¹ The organization published research showing that nearly one in four American workers, or 24 percent of the surveyed labor force, report currently remaining in an unwanted job solely to maintain employer-provided medical coverage.¹ The findings show that healthcare considerations now function as a primary barrier to career movement and economic mobility for millions of people.¹

Why are more workers staying in unwanted jobs for insurance?

Rising medical costs and direct exposure to household debt are driving employees to prioritize coverage over career choice. The study by the West Health-Gallup Center on Healthcare in America found that the share of workers experiencing job lock increased by eight percentage points since 2021, representing an increase of one third over that period.¹ The surge reflects deepening concern among workers about their ability to manage unexpected medical bills without employer backing.

The pressure is particularly severe for employees who already owe money for past medical care. The study showed that workers with personal or household medical debt, who represent 20 percent of the surveyed group, are more than twice as likely to remain in unwanted jobs because they fear losing insurance, with 44 percent reporting job lock compared with 21 percent among workers without medical debt.¹ A similar pattern emerged among workers who borrowed money in the past year, where 37 percent reported remaining in unwanted positions for coverage compared with 22 percent of those who had not borrowed.¹

Worry about prospective bills also plays an influential role. The researchers reported that nearly half of surveyed Americans, or 48 percent of those who view healthcare expenses as a major financial burden, report remaining locked in jobs they do not want out of fear that a medical emergency might occur.¹ Among employees who experience a lot of daily stress regarding the cost of care, 53 percent say they remain in an unwanted job to protect their benefits.¹

Tim Lash, president of the West Health Policy Center, stated that the widespread feeling of compulsion reveals how medical costs reach into everyday economic choices.¹ Lash said in response to the findings: “That so many Americans feel compelled to stay in jobs they no longer want simply to keep their health insurance underscores how healthcare affordability influences decisions far beyond any immediate or future illness or condition. No one should have to choose between seeking a better opportunity or maintaining access to health insurance. Yet for millions of Americans, the high cost of healthcare has left them facing this exact choice.”¹

Broader metrics from the organization reflect this widespread distress. Data from the West Health-Gallup Affordability Index showed that just 49 percent of American adults report that they can afford access to quality care and have been able to pay for clinic visits and prescription drugs in recent months.¹ The authors noted that this represents the first instance in five years where fewer than half of surveyed Americans report an ability to consistently afford care.¹

Which groups face the highest rates of job lock?

Employees managing chronic illnesses and women experience job lock at significantly higher rates than the broader workforce. The survey found that workers diagnosed with chronic health conditions report job lock at a rate of 29 percent, compared with 17 percent among healthier peers.¹ The study documented that the probability of staying in an unwanted role climbs higher as an individual’s number of chronic conditions grows.¹

For individuals with complex medical needs, the risk of losing continuous treatment creates an urgent imperative to remain employed. More than 40 percent of workers with three or more chronic health conditions reported staying in an unwanted job to preserve their medical insurance.¹ High rates also appeared among employees managing diseases that demand ongoing or intensive management, including 29 percent of workers with asthma and 36 percent of workers with immune-compromising conditions.¹ Mental health conditions showed comparable elevated levels, with 35 percent of employees with depression and 33 percent of employees with anxiety reporting that they remain in unwanted jobs for insurance.¹

The study also revealed substantial disparities along gender lines. Three in 10 women, or 30 percent of female workers, reported staying in a position they would prefer to leave in order to maintain health insurance, compared with 20 percent of men.¹ This gap parallels wider inequalities in medical expenses, as women were more likely than men to report healthcare-related financial stress, at 56 percent, medical debt, at 22 percent, and multiple chronic conditions, at 66 percent.¹

Joe Daly, global managing partner at Gallup, noted that healthcare benefits exert a strong hold over workplace mobility.¹ Daly said: “Health insurance continues to play an important role in how Americans navigate the labor market. As job lock has become more common among workers with employer-sponsored coverage since 2021, the findings offer insight into how healthcare benefits may factor into decisions about staying in a job or pursuing other opportunities.”¹

What can the study measurements show and what remains uncertain?

The findings are based on representative polling data that capture workers’ self-reported reasons for remaining in their current jobs rather than longitudinal tracking of employment exits. The survey measured how employees perceive their options and how healthcare costs affect their career choices during late 2025. Like all survey research, the responses reflect participants’ reported motivations at a given moment in time rather than administrative employment records.

The 2025 results came from a Gallup Panel study conducted between October 27 and December 22, 2025, with 5,660 American adults aged 18 and older participating.¹ The researchers weighted the sample to align with demographic benchmarks from the Current Population Survey, producing a maximum margin of sampling error of plus or minus 2.1 percentage points at the 95 percent confidence level for the full sample.¹ Margins of error are higher for smaller demographic subgroups.¹ The comparative 2021 baseline came from a similar survey of 4,843 adults conducted across two intervals, September 27 to 30 and October 18 to 21, 2021.¹

The research illustrates how medical financing constraints restrict professional mobility across the economy. Because employees remain in positions they would otherwise leave, the phenomenon reduces labor dynamism and limits opportunities for career progression. Future investigations will need to track whether policy measures that decouple medical coverage from employment can restore mobility for workers carrying chronic illnesses and medical debt.

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