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From Health Affairs:


New Findings About The ACA's Impact On Employer-Sponsored Health Insurance



Bethesda, MD--Since the Affordable Care Act (ACA) was signed into law, some of its critics have predicted that businesses would discontinue offering employer-sponsored health insurance, moving employees into the individual Marketplaces. If widespread dropping of employer-sponsored health insurance were to occur, government costs could increase since many low-wage workers would qualify for federal subsidies in the Marketplaces. A new study, released today as a Web First by Health Affairs, examined data from the Health Reform Monitoring Survey for June 2013 through September 2014, assessing any early changes of employer-sponsored insurance under the ACA. It found that the percentage of workers with employer offers for health insurance was basically unchanged between June 2013 and September 2014: 82.7 percent versus 82.2 percent. Worker take-up of employer coverage and overall coverage rates also remained constant. There were no changes in offer, take-up, and coverage rates among low- and high-income adults working at small (fewer than fifty workers) or large firms. This is the first peer-reviewed study to analyze changes in employer-sponsored insurance after the ACA was implemented and the launching of the health insurance Marketplaces.

An Early Look At Changes In Employer-Sponsored Insurance Under The Affordable Care Act


By Fredric Blavin, Adele Shartzer, Sharon K. Long, and John Holahan


The authors are with the Health Policy Center at the Urban Institute, in Washington, D.C.


This study, which will also appear in the January 2015 issue of Health Affairs, is supported by the Robert Wood Johnson Foundation, the Ford Foundation, and the Urban Institute.


The authors also noted that between 2000 and 2013, national rates of coverage through employer-sponsored insurance had decreased every year, with the largest declines during the 2001 and 2007-09 recessions. "Absent the ACA, we might expect the decline to continue... However, the improving economy and tightening labor markets could result in some increase in offer rates," they observed. While it might still be too early to see the full results of the ACA on employer-sponsored insurance, the study's findings suggest that many workers will continue to obtain health insurance through employers. "The incentives in current law, including the strong tax incentives to obtain coverage from employers because of the tax exemption of employer contributions to insurance and the individual mandate, remain a strong force," the authors concluded. "The tax incentives mean that most workers are financially better off if they obtain insurance coverage via employment. Since the ACA requires many people to obtain coverage or pay a penalty, there are new incentives for employers to maintain their offers of coverage and for people to take up coverage when it is offered."


About Health Affairs

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically at The full text of each Health Affairs Web First paper is available free of charge to all website visitors for a one-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund. You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download our podcasts, including monthly Narrative Matters essays, on iTunes. Tap into Health Affairs content with the new iPad app.