Fewer Americans got their health insurance from an employer in 2011 (44.6%) than in 2010 (45.8%), continuing the downward trend Gallup and Healthways have documented since 2008. As employer-based health insurance has declined, the percentage of Americans who are uninsured has increased, rising to 17.1% this year, the highest seen since 2008. Two factors appear to be driving up the percentage of uninsured Americans. First, more Americans were unemployed or underemployed in 2011 than in 2008. Second, fewer employees had health insurance from their employer, which may be because employers no longer offered it or the cost was too high for employees to afford.