Health Aff (Millwood). 2025 Nov;44(11):1349-1358. doi: 10.1377/hlthaff.2025.00299.
ABSTRACT
Adults with employer-sponsored insurance may remain in employment to retain health coverage for their children-a phenomenon we term dependent-related job lock. Using 2016-23 National Survey of Children’s Health data, we estimated the prevalence of dependent-related job lock among families with children covered by employer-sponsored insurance and examined associations with caregivers’ health. Nationally, 8.9 percent of such families reported dependent-related job lock, with higher rates seen among families with children with special health care needs, particularly those with emotional, behavioral, and developmental problems (23.1 percent). Dependent-related job lock was associated with a 4.5-7.1-percentage-point increase in poor or fair caregiver mental health and a 3.7-4.3-percentage-point increase in poor or fair caregiver physical health across groups of children with special health care needs. Sensitivity analyses adjusting for employment suggested some confounding. Findings underscore the need for policy reforms to address insurance-related barriers, reduce disparities in caregivers’ health, and promote equitable employment mobility.
PMID:41183232 | DOI:10.1377/hlthaff.2025.00299
