Dive Brief:
- The rate of coverage under employer-sponsored health plans has stayed stable during the past few years, even under the full implementation of the Affordable Care Act (ACA), according to the Health Reform Monitoring Survey funded by the Urban Institute and the Robert Wood Johnson Foundation.
- The report found even those with the least secure employer-sponsored insurance (ESI), including low-income employees and those working for small businesses, have held on to their employer insurance.
- Prior to the ACA there had been a long-term decline in ESI that was expected to continue or worsen due to the ACA, but if anything, it has somewhat increased, researchers said.
Dive Insight:
The report appears to refute concerns that the ACA would mean the near-death of employer-sponsored coverage, and suggest healthcare reform has actually somewhat bolstered it.
"Although it is too soon to know the long-term course of ESI, we are now over two years into the implementation of the ACA’s major insurance coverage expansions. Accordingly, if such a drop off in employer coverage were to occur, we should begin to see it," the researchers argued.
The study examined ESI offer, take-up, and coverage rates between June 2013 and March 2016.
The authors laid out several reasons to explain why ESI take-up has actually gone up for higher-income employees at large firms, including the individual mandate and tax incentives that position most workers to be better-off by obtaining ESI coverage, and employer requirements around offering ESI. "Employers now have increased incentives to maintain their offers for coverage and workers have increased incentives to take up that coverage when it is available," they wrote. "The combination of the individual mandate and the tax exclusion of employer contributions to health insurance create powerful incentives for the continuation of ESI."