Health insurance costs are turning career decisions into financial survival decisions for millions of Americans who may be ready to quit, change industries, or work for themselves but cannot risk losing affordable medical coverage.
New research suggests the problem is getting worse. According to the West Health Gallup Center on Healthcare in America, 24 percent of employed adults who rely on insurance through their jobs say they are staying in positions they want to leave because they are afraid of losing their coverage. Gallup estimates that represents roughly 23 million adults.
That is a sharp increase from 2021, when 16 percent of workers surveyed reported the same problem. Gallup based its latest findings on a nationally representative study conducted from October 27 through December 22, 2025, including an analysis of 2,322 employed adults who primarily receive health insurance through work.
The numbers point to a workplace problem that goes beyond whether employees like their bosses, their schedules, or their salaries. As health insurance costs climb, having a job with coverage can become too valuable to surrender, even when the actual job is no longer working for the person doing it.
The price of that security is substantial. According to KFF’s 2025 Employer Health Benefits Survey, the average annual premium for employer provided family health coverage reached $26,993 in 2025, an increase of 6 percent in one year. Workers contributed an average of $6,850 of that total from their own paychecks. Average single coverage cost $9,325 annually, with workers contributing $1,440.
For someone considering leaving a job, those figures help explain why a new opportunity cannot always be judged by salary alone. Workers may also have to calculate what a new insurance plan will cost, whether their doctors remain covered, what deductible they will face, and how much exposure they would have if a health emergency happened during a coverage transition.
Ellyn Maese, a research director for the West Health Gallup Center, put the issue bluntly while discussing the findings with NPR. As reported by Georgia Public Broadcasting in NPR’s syndicated report, Maese said, “Anybody having to stay in a job just to keep their health insurance, knowing that they want to leave, is crazy.”
“That is a concerning figure, even if it’s 10%. But when we’re seeing it rise to 1 in 4 employees, that’s pretty serious.”
The burden becomes even clearer when health insurance costs collide with ongoing medical needs. Gallup found that 29 percent of workers with at least one chronic health condition reported job lock, compared with 17 percent of workers without those conditions. Among people reporting three or more chronic conditions, the rate jumped to 41 percent.
Money problems surrounding medical care also appear closely connected to feeling trapped at work. Gallup found that 44 percent of workers with personal or household medical debt said they stayed in an unwanted job for insurance, compared with 21 percent of workers without medical debt. Among workers who described health expenses as a major financial burden, 48 percent reported job lock. The rate reached 53 percent among people experiencing a lot of daily stress because of health care costs.
That makes rising health insurance costs more than another item in the household budget. For some workers, they can influence whether changing jobs feels financially possible at all.
The concern extends well beyond workers currently considering resigning. The NPR report cited an April KFF poll finding that nearly two thirds of adults were worried about being able to afford health care. Larry Levitt, executive vice president for Health Policy at KFF, connected those fears directly to employment decisions.
“Healthcare tops the list of economic worries right now,” Levitt said. “So it stands to reason that people would be concerned about leaving an unwanted job for fear of losing their health insurance.”
The economic consequences can stretch far beyond one unhappy employee remaining at one company. People who feel unable to leave may pass on better paying jobs, delay career changes, or decide that entrepreneurship is simply too risky when losing a benefits package could expose their families to higher insurance and medical expenses.
“Leaving, moving, becoming entrepreneurs,” Maese said, “is what we need to see for our economy to really thrive.”
Gallup similarly concluded that job lock can constrain worker mobility, entrepreneurship, wage growth, and labor market efficiency. The research found the highest job lock rate by income at 27 percent among workers living in households earning $48,000 to less than $90,000 annually.
That income range is especially important as workers weigh health insurance costs against what they might pay for coverage outside the workplace.
One option for people leaving jobs is purchasing insurance through an Affordable Care Act Marketplace. But the rules changed for 2026 after temporary expansions to the Premium Tax Credit ended.
According to current IRS guidance, Congress temporarily expanded eligibility for Marketplace premium tax credits from 2021 through 2025 by removing the usual income ceiling of 400 percent of the federal poverty level. Beginning with 2026, the general rule once again limits Premium Tax Credit eligibility to households with income between 100 percent and 400 percent of the federal poverty level, provided they meet the other eligibility requirements.
That shift can leave some people considering a job exit with fewer protections against the full cost of buying insurance independently. It also adds another calculation for middle income workers who earn too much for certain assistance but may still struggle with the full price of coverage.
“They don’t really qualify for assistance, but they also don’t make enough to be able to catch up with the rising costs of healthcare,” Maese said.
The problem is not limited to one proposed solution or one political viewpoint. Michael Cannon, director of Health Policy Studies at the Cato Institute, acknowledged the underlying issue while arguing that tying health coverage so closely to employment comes with economic consequences.
“Everyone acknowledges that job lock is real,” Cannon said. “Whether the extent of job lock is 8%, 24%, or something else, favoring employer-sponsored health insurance creates coverage gaps, reduces income mobility, and is crying out for reform.”
For workers, the larger question may be less complicated than the policy debate. A job is supposed to provide income and opportunity, but for millions of Americans, leaving one now requires calculating the possible price of getting sick afterward.
As health insurance costs rise, the freedom to walk away from a workplace that no longer serves you can become a benefit of its own, and increasingly, it is one many workers do not believe they can afford.
