Employer Mandate Strongly Supported By
Working-Age Americans And Californians, Survey Says

California’s Health Insurance Measure, Presidential Candidates
Put Mandated Worker Coverage Back In The Spotlight

BETHESDA, MD — As California prepares to vote on whether to repeal recent legislation requiring employers to pay for health insurance for employees, nearly half of Californians and half of Americans agree that the government should mandate coverage for all workers, according to a survey published today by Health Affairs and the California HealthCare Foundation.

The survey of 1,479 working-age adults conducted in November-December 2003 found overwhelming support for some form of employer mandate in both California and the rest of the country, according to the survey’s authors, Claudia L. Schur and Marc L. Berk of NORC at the University of Chicago in Bethesda, Maryland, and Jill Yegian of the California HealthCare Foundation in Oakland.

In addition to those supporting a full employer mandate, about one-quarter of working-age adults expressed support for mandated coverage for some workers, and another 10 percent expressed support for an employer mandate for large employers only.

Opposition to any kind of mandate was small. Thirteen percent of working-age adults in California and 10 percent of those in the United States as a whole opposed a mandate, according to the survey, published today as a Health Affairs Web exclusive.

“Support for mandated coverage may reflect increasing anxiety among Americans as they observe—and experience—the effects of increasing medical care costs,” write Schur and colleagues. “If so, support for mandated coverage may continue unless alternative solutions address underlying concerns.”
Support for a full employer mandate was stronger among minorities, the poor, the uninsured, and those with less education; members of those same groups were less likely to believe the mandate would adversely affect their own wages or employment status.

Some other findings:

Among those advocating an employer mandate (full or limited):

• 81 percent of Californians and 85 percent of Americans were in favor of including dependent coverage in the employer mandate.
• 74 percent of Californians and 73 percent of Americans believe that there should be assistance for low-income workers to pay their premiums.
• 65 percent of Californians and 70 percent of Americans believe that employers should be required to pay for most of the cost of health insurance for their employees.

Schur is a principal research scientist with NORC, where Berk is vice president and senior fellow. Yegian is director of health insurance at CHCF.

The article can be read at content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.128.

Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research.

The California HealthCare Foundation, (CHCF) based in Oakland, is an independent philanthropy committed to improving California’s health care delivery and financing systems. Visit www.chcf.org for more information.

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©2004 Project HOPE–The People-to-People Health Foundation, Inc.