The percentage of U.S. workers offered health coverage by their employers will rise from 84.6 percent to 94.6 percent after full implementation of the Patient Protection and Affordable Care Act, according to a Rand Corp. simulation published online by the New England Journal of Medicine last week. That would mean 13.6 million more covered workers.
The Rand study rebuts health reform critics who say employers are likely to drop coverage because individuals will be able to buy subsidized insurance on their own through the exchanges and lower-income workers will qualify for Medicaid. But the authors cautioned that the increase in employer coverage will depend on how well the states implement the new health insurance exchanges in terms of administrative savings and the quality of plans offered.
The simulation predicted individuals' and employers' decisions based on the benefits of an option versus the costs. Employers with fewer than 50 workers particularly will be more likely to offer coverage because all workers must have insurance by 2014, plus the exchanges should generate administrative savings resulting in lower-cost health plans, concluded the authors. They estimate the percentage of workers offered coverage by smaller firms will increase from 60.4 percent to 85.9 percent. The impact will be less for workers at firms with more than 50 workers, since most already offer coverage.
Employer-sponsored coverage, either provided directly or through the exchanges, will remain "very robust" due to an increased employee demand for health insurance, the authors said. That's consistent with the evidence from Massachusetts, where more employers offered coverage after the 2006 state health reform law passed.
But many employers, they said, are likely to buy through the exchanges due to wider risk pooling, low administrative costs and expanded choices.
To learn more:
- read the New England Journal of Medicine article
- see the Los Angeles Times article
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