The population with employer-sponsored health insurance (ESI) includes individuals who receive health insurance coverage from an employer, including employees and their dependents, such as spouses and eligible children. Half of the children in the U.S. are covered by ESI, making this form of coverage the largest source of insurance for American children. In this report, we present data on health care spending, utilization, and average prices among children (under age 18) who receive health insurance coverage through an employer. In HCCI's 2020 data, one-quarter of ESI enrollees were 18 years old or younger. The report relies on de-identified commercial health insurance claims contributed by CVS Health/Aetna, Humana, and Blue Health Intelligence.

• In 2020, average per person spending among those under the age of 18 was $2,966. In comparison, average per person spending among those ages 18-64 was over twice as high, $6,429.
• The difference in spending between adults and children is largely due to lower use of health care services, on average, among children. Prices for health care services generally were similar across the two populations.
• A greater share of children's health care spending was on hospital inpatient and professional (physician and other clinician) services compared to adults.
  
• Total health care spending grew more for children (16.1%) than adults (13%) from 2016-2019, however there was a more substantial drop in health care spending among children in 2020. As a result, from 2016 to 2020, spending per person increased only 2.5% among children compared to 10% among adults.