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Access to Health Insurance Drives Better Health Outcomes

The majority of Americans still rely on health insurance to access affordable health care services. In the U.S., health care spending continues to rise, with average per person spending topping $11,000 in 2018. For most Americans, the high cost of care means that not having health insurance is almost the equivalent of being shut out of our health care system.

Health Insurance Among Union and Non-Union Construction Workers

Despite the clear need for health insurance, a recent data bulletin from CPWR – The Center for Construction Research and Training – found that in 2018, nearly 1 in 4 construction workers didn’t have any health insurance. This was the highest percentage of workers without health insurance in any industry and was more than double the uninsured rate (11 percent) for the average U.S. worker.

Image from CPWR Data Bulletin: Health Coverage in the Construction Industry


Even for construction workers who did have health insurance, the availability and extent of that insurance often varied greatly. About 7.5 percent of construction workers purchased their own health insurance because employment-based insurance in construction is much less common than it is in other industries. There’s an exception to that trend, though. Union workers were far more likely to have insurance through their employer. Approximately 70 percent of union workers reported having employment-based health insurance, compared to only 47 percent of non-union workers.

Image from CPWR Data Bulletin: Health Coverage in the Construction Industry


Almost half of union construction workers had their premiums fully paid by their employer, while less than a quarter of non-union workers had that same benefit. Additionally, almost 70 percent of union members’ health insurance also covered their family members, while less than 40 percent of non-union members could say the same. When analyzing health insurance across the construction industry, unionization is associated with increased coverage and higher quality coverage for workers.

Existing Health Insurance Disparities

In the U.S., Hispanic construction workers are more likely to lack health insurance than Whites. In 2018, 48 percent of Hispanic construction workers didn’t have health insurance compared to 13 percent of Whites. As CPWR’s recent data bulletin shows, what’s even more troubling is that after several years of improvement, this insurance gap is widening once again. Only one third of Hispanic construction workers have health insurance based on their employment, leaving many workers with two bad options – going without health insurance or buying it on private markets, where coverage tends to be more expensive than employer-sponsored coverage.

In a recent report, the CDC noted significant disparities in access to care across the U.S. by sex, age, race, ethnicity, education, family income and geography. Clearly, there’s a lot of work to be done when it comes to ensuring equitable access to health insurance.

The Power of Health Insurance to Improve Health

Access to health care improves a person’s physical and mental health status and quality of life. People without health insurance are much more likely to postpone necessary treatment or go without it altogether, to be financially burdened by medical bills when they do get treatment and to be diagnosed later when they have serious and chronic health conditions.

When health insurance is the gateway to treatment for acute injuries, chronic pain and countless other health conditions, it’s especially concerning that so many workers in the construction industry don’t have health insurance. Construction workers face many different physical hazards and health hazards on the job that put them at higher risk for workplace injuries and illnesses. This higher risk makes construction workers more likely to need our health care system during their working years and after their careers are over.

Health Insurance a Key Union Benefit

Access to health insurance – especially the excellent coverage typically provided through union health and welfare funds – is one of the many benefits of being a union member. In addition to better working conditions and bargaining power, LIUNA organizers may be able to focus on health benefits when organizing non-union workplaces. While many non-union firms provide their employees with health coverage, these benefits can be among the first to be scaled back during difficult economic times as employers try to lower costs. Union members, on the other hand, enjoy consistent access to health care coverage as long as required working hours are met, because health insurance is a benefit that’s been agreed upon at the bargaining table.

[Nick Fox]

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