Rates of employer-sponsored healthcare have not declined since the implementation of the ACA, according to Fredric Blavin, a Senior Research Associate at the Urban Institute’s Health Policy Center. These findings, published in the January 2015 issue of Health Affairs, are based on his analysis of the Health Reform Monitoring Survey. Researchers at the Urban Institute administered this survey to workers between June 2013 and September 2014, asking if they are/were employed and if they are/were offered employer-sponsored health coverage. Analysis of these national data, displayed in figure 1, suggests that rates have remained statistically constant. The pre-existing and new ACA economic incentives for workers to obtain coverage from employers remains strong; the feared erosion has not yet materialized.
Massachusetts An Early Example
Earlier studies on Massachusetts’ employer-sponsored insurance market support Blavin’s findings. Between fall 2006 and fall 2009, a period of time which included adoption of the state’s health reforms, the rate of employer-sponsored insurance increased by 3%.
ACA Provisions Prevented Downward Direction
Incentives in the healthcare law have restrained the predicted drop-off in employer coverage. Provisions, such as ongoing preferential tax treatment of premiums through payroll deductions and the mandate to provide coverage for businesses with 50 or more workers, have persuaded employers to continue offering plans.
But Small Firms Are Left Out
One notable result from this survey is the nagging imbalance between large firms and small firms offering coverage. Although mechanisms like the small employer tax credit and the SHOP Marketplace are meant to close this gap, small businesses have not taken advantage. Outreach and education with small businesses represents a large opportunity for insurance coverage expansion. Small employers need information to understand provisions of the ACA in order to provide health insurance options to this growing workforce.
Michele Thornton, MBA
Insurance and Benefits Consultant
