One in four US workers stay in jobs for health insurance

Clinical takeaway: Feeling locked into a job rises sharply with chronic disease burden, reaching more than 40% of workers with three or more conditions. Coverage fears may be shaping patients' work and care decisions in ways they don't volunteer.

Healthcare affordability is usually measured in skipped prescriptions and delayed visits. A new West Health-Gallup survey points to a quieter cost: workers staying in jobs they want to leave because quitting means losing coverage. Nearly one in four US workers now reports this kind of job lock, up 8 percentage points since 2021. The burden falls hardest on people with chronic conditions and medical debt, the same patients clinicians see most often.

The trend tracks a wider erosion in what Americans can pay for. In the companion West Health-Gallup Affordability Index, just 49% of US adults say they can consistently afford quality care, physician visits, and prescriptions, the first reading that's below a majority in five years.

Among workers with chronic conditions, 29% stay in unwanted jobs for the insurance, versus 17% of healthier workers, and the share tops 40% for those with three or more conditions. Depression (35%), immune-compromising conditions (36%), and anxiety (33%) all carry above-average rates. Medical debt more than doubles the likelihood (44% vs 21%), and among workers reporting a lot of daily stress over healthcare costs, it reaches 53%.

Women report staying for coverage at higher rates than men, 30% versus 20%. That gap sits on top of broader disparities: women are more likely to report healthcare-related financial stress (56%), medical debt (22%), and multiple chronic conditions (66%), all of which track with staying put. Workers who borrowed money in the past year also report elevated rates, 37% versus 22% of non-borrowers.

Results are based on a Gallup Panel survey of 5,660 US adults fielded October 27 to December 22, 2025, weighted to be demographically representative, with a maximum sampling error of ±2.1 percentage points; subgroup margins run higher. The trend comparison uses a similar 2021 survey of 4,843 adults.

The pattern inverts the usual framing of insurance as a safety net: for the sickest workers, coverage functions more like a constraint. Patients managing several conditions may be organizing major life decisions around keeping their plan, which can mean staying in work that adds stress to the conditions being treated.

"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," said Tim Lash, president of the West Health Policy Center. "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."

Source: West Health Institute. (2026 Jul 22) 1 in 4 American workers report staying in unwanted jobs for health insurance