ACA impact on employer health coverage shows mixed results

The question of whether the Patient Protection and Affordable Care Act will result in more Americans having health insurance through their employers remains unresolved, according to a newly released report from the Government Accountability Office (GAO).

The report finds projections range from a 2.5 percent decrease to a 2.7 percent increase in the number of employees with coverage in the near term, depending on the study.

Increases in coverage were projected in three of the five studies reviewed by the GAO that employed microsimulation models. The three studies were conducted by the Centers for Medicare & Medicaid Services, the RAND Corp. and the Urban Institute/Robert Wood Johnson Foundation.

The Congressional Budget Office, meanwhile, projected a 2.5 percent net decrease in coverage. The Lewin Group projected a net decrease of 1.6 percent, according to the findings.

Key provisions affecting employer-provided health insurance take effect in 2014.

Employer surveys "varied widely" in their findings, the GAO reported, with 11 of 16 surveys indicating 10 percent or fewer of employers were likely to drop coverage in the near term. Five surveys pegged the figure at 11 percent to 20 percent. The auditors noted the surveys did not reflect the number of employers likely to begin offering coverage under the Affordable Care Act.

The GAO study was conducted to determine whether the availability of subsidized health insurance through insurance exchanges, or the individual mandate requiring most people to obtain health insurance, would affect whether employers offer health insurance to their workers.

Without the individual mandate, four microsimulation studies estimated that between 2 million and 6 million fewer people would have employer-sponsored coverage, the GAO found.

Four of the employer surveys found that smaller employers were more likely to drop employee health coverage because of the AFA. Five found that retiree health coverage was more at risk overall than coverage for active employees, according to highlights of the findings.

Meanwhile, a report released in July by The Commonwealth Fund found that the number of uninsured women between the ages of 19 and 64 rose from 12.8 million in 2000 to 18.7 million in 2010. The report also found that another 16.7 million women were underinsured because their out-of-pocket costs were so high relative to their income. It concluded that the Affordable Care Act would reduce the healthcare cost exposure for women by significantly expanding health-insurance coverage.

The Commonwealth Fund report noted that women buying individual coverage currently pay higher rates than men in most states.

 To learn more:
-read the full GAO report (.pdf)
-see the report highlights

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