Contrary to some of the passionate but either misinformed or—to be generous—misspeaking proponents of Obamacare, I don’t believe health insurance to be a right of the people. I vacillate on health care—chiefly on the use of the word “right.” Perhaps just antics with semantics, but I believe all U.S. citizens should have access to health care. Whether it is the public’s right, in a Bill of Rights sense, or society’s and our government’s responsibility to do the right thing and be sure all citizens in need of health care have a way to obtain it regardless of true ability to pay. My seemingly unquenchable cynicism flourishes in the contemplation of our legislature’s ability to actually achieve that in anything resembling a cost efficient manner. And I simply can’t, even in my most sincere Socialist role-playing fantasies, see the Affordable Care Act (ACA), from a taxpayer standpoint, as anything but an oxymoron. But I must confess that, like (I’m convinced) every single member of the Congress who voted for it, I haven’t read it.
But perhaps I digress. Where does the employer-paid health insurance industry stand today? I looked at the recent annual study from the International Foundation of Employee Benefits Plans (IFEBP—www.ifebp.org) titled 2015 Employer-Sponsored Health Care: ACA’s Impact and was somewhat reassured that many of us may still have a job in 2016. That’s something at least.
The survey responses provided an in-depth study of how single employers are being affected by the ACA. Surveyed were single employer plans (including corporations) in the databases of the IFEBP and the International Society of Certified Employee Benefit Specialists (ISCEBS). Responses were received from 598 human resources professionals, benefits professionals and industry experts. Results represent a wide base of U.S. employers, from nearly 20 industries, ranging in size from fewer than 50 employees to more than 10,000.
The study showed that 94 percent of those responding provide health care coverage to all full-time employees (30+ hours per week), and of those, 98.2 percent feel that they will continue to do so in 2016. However, the likelihood that they will continue to offer coverage five years from now is more uncertain: 33 percent said they definitely will; 52 percent said it is very likely; nearly 11 percent said it was somewhat likely.
Philosophical reasons for doing so were predictable—the majority claiming to do so to attract future talent, to retain current employees and to maintain/increase employee satisfaction and loyalty. On the perhaps “less benevolent” list of reasons cited were: to continue to avoid penalties (14.3 percent); to maintain tax advantage (14.1 percent); and to maintain/increase productivity (13.7 percent).
Predictably cited as the most likely cause of discontinuing benefits was cost (65.7 percent). Surprisingly, 17.4 percent cited as a cause of discontinuing that “Exchanges are proving to provide adequate health coverage for individuals.” An amazing 0.0 percent predicted the cause as “Employees voluntarily moving to the exchanges.”
Cost containment is clearly a paramount concern for employers, and the study showed that those costs are continuing to shift to employees. Cost containment measures taken due to ACA—change from 2013 to 2015:
• Increase out-of-pocket limits—13.8 percent to 40.6 percent.
• Increase in-network deductibles—14.9 percent to 36.8 percent.
• Increase participants’ share of premium costs—18 percent to 34.5 percent.
• Increase copayments or coinsurance for primary care—12.7 percent to 27.6 percent.
• Increase participants’ share of prescription drug costs—11.7 percent to 27.2 percent.
• Increase employee portion of dependent coverage cost—10.4 percent to 23.8 percent.
Heartening, I suppose, that although employers are establishing cost containment lines and shifting costs beyond those lines, they continue to see value in continuing health care benefits for full-time employees rather than simply abandoning them to seek coverage individually on the exchange. In the face of a variety of impending nightmares surrounding administrative costs still to be inflicted by the ACA, I find single employers’ willingness to continue to provide health benefits to employees admirable. And it makes me feel less like an idiot myself. [SPH]
