Nearly a quarter of American workers who get health insurance through their employer say they want to leave their job but will not, because they are afraid of losing coverage.
The finding comes from a study by the West Health-Gallup Center on Healthcare in America, which reports that 24 percent of such workers, about 23 million adults, describe that situation. That is up significantly from 16 percent in 2021, the last time Gallup measured job lock.
For households, this is a coverage question wearing the clothes of a career question. A worker weighing a better job, a move closer to family, or leaving to start something of their own is running a calculation about deductibles and prescriptions rather than about salary.
Numbers and Who Was Actually Surveyed
Methodology matters here, because the headline figure describes a specific population rather than the whole labor force.
The study was conducted from October 27 to December 22, 2025, with 5,660 U.S. adults aged 18 and older drawn from the Gallup Panel, surveyed by web and mail. The analysis focuses on 2,322 employed respondents who rely on employer-sponsored insurance as their primary coverage.
That means the 24 percent applies to insured workers, not to all American workers. People who are uninsured, self-employed, covered through a spouse, or on Medicaid or Medicare are outside the denominator. The maximum margin of sampling error is plus or minus 2.1 percentage points for the full sample and higher for subgroups.
The measure is also self-reported. It captures what workers say about their own reasons for staying, which is the appropriate way to study a psychological constraint but is not the same as observing job changes in employment data.
Even with those limits, the direction is unambiguous, and the finding fits other polling. Larry Levitt of KFF, who was not involved in the study, told NPR that the findings fit what KFF polling has found. The share reporting job lock rose by half in four years, during a period when the same research found fewer than half of Americans (49 percent) could afford needed care and medications, and 51 percent were worried about affording care over the next year, a five-year high.
Medical Debt and Chronic Illness Raise the Stakes
The burden is not evenly distributed, and the sharpest divide is financial rather than clinical.
Workers with medical debt were twice as likely to report job lock as those without it, 44 percent against 21 percent. People who borrowed money in the past year also reported it at higher rates, 37 percent against 22 percent, and nearly half of Americans who consider health care costs a major financial burden, 48 percent, said they were locked into jobs they did not want.
Health status compounds it. Among working adults with three or more chronic health conditions, 41 percent reported staying in jobs they disliked out of fear of losing coverage. Someone managing diabetes, an autoimmune condition, cancer or a mental health condition faces a different calculation than a healthy 26-year-old, because a lapse in coverage can mean an interrupted medication, a canceled specialist appointment, or a prior authorization process starting over with a new plan.
Job lock is not a new idea. Economists have studied it for decades as a consequence of tying health coverage to employment, and analysts across the political spectrum agree the phenomenon is real while disagreeing on the remedy. Michael Cannon of the Cato Institute, who questions the specific magnitude, has argued that favoring employer-sponsored insurance creates coverage gaps and reduces income mobility, and that coverage should belong to individuals rather than jobs.
Job Lock as an Economic Concept
Economists care because job lock has effects beyond the individual worker.
Ellyn Maese, the research director who authored the report, wrote that the consequences extend beyond morale, reducing labor market efficiency, upward mobility and quality of life. She also noted that unhappy workers are more likely to suffer occupational injuries, and that the findings may be compounded by pessimism about the job market. A separate Gallup poll in May found just 28 percent of U.S. workers said it was a good time to find a job, the lowest since 2013.
When people cannot move to roles that better match their skills, cannot relocate, and cannot leave to start a business, labor market efficiency declines. Entrepreneurship research has repeatedly found that access to coverage outside employment increases business formation, which is why this survey draws attention from people who do not otherwise study health policy.
It also creates leverage. Coverage that a worker cannot easily replace functions as a retention tool whether or not an employer intends it that way, and workers in that position have less ability to negotiate pay, hours, or working conditions.
Practical Options Before Leaving a Job
Anyone considering a departure has more coverage paths than they may realize, and the useful step is checking them before resigning rather than after.
Losing job-based coverage is a qualifying life event that opens a special enrollment period on the health insurance marketplace, generally 60 days. Marketplace plans are worth pricing before assuming they are unaffordable, since subsidies depend on projected income for the coming year rather than current salary.
COBRA allows continuation of the existing plan, typically for up to 18 months, but the worker pays the full premium plus an administrative fee, which is usually far more than the payroll deduction they are used to. It preserves the same doctors and the same deductible progress, which can be worth the cost mid-treatment.
Other options include enrolling in a spouse's or parent's plan, which also triggers a special enrollment window, Medicaid for those who qualify based on income, and coverage through a professional association or union.
People in active treatment should ask their clinician's office which plans that practice accepts before choosing, and should ask a pharmacist to check whether current medications are on a prospective plan's formulary. Those two calls prevent most of the disruptions that make job changes go badly.
Nobody should stop a prescribed medication or defer a scheduled procedure while sorting out coverage. If a gap is unavoidable, prescription assistance programs and community health centers can bridge it.
The bottom line: the newest finding is that 24 percent of workers with employer coverage report staying in unwanted jobs to keep it, up from 16 percent in 2021; the burden falls hardest on people carrying medical debt and those with multiple chronic conditions, and anyone considering a move should price marketplace coverage and check formularies before resigning.
Key Questions Answered
What is job lock? Staying in a job you want to leave because you are afraid of losing health insurance. Economists have studied the concept for decades.
How many people does the survey describe? About 23 million adults, equal to 24 percent of workers who rely on employer-sponsored insurance as their primary coverage.
Who was surveyed? 5,660 U.S. adults from the Gallup Panel between October 27 and December 22, 2025, with a margin of error of plus or minus 2.1 points. The job lock figure comes from a subset of 2,322 employed respondents with employer coverage.
Does this apply to all American workers? No. It describes workers whose primary coverage comes from their employer. It excludes the uninsured, self-employed, and people covered elsewhere.
Who is most affected? Workers carrying medical debt, 44 percent of whom report job lock, and working adults with three or more chronic conditions, at 41 percent.
What coverage options exist after leaving a job? A marketplace special enrollment period of generally 60 days, COBRA continuation at full premium cost, a spouse's or parent's plan, Medicaid for those who qualify, or association coverage.
What should someone in treatment check first? Whether their clinician accepts a prospective plan, and whether current medications are on that plan's formulary.
