- With some critics arguing the ACA has driven health insurance costs up for businesses and workers using employer-based plans, The Commonwealth Fund sought to compare cost growth in employer coverage during the five years before and the five years after 2010, when the ACA was enacted, as well as examine changes in workers’ incomes over that time.
- The employer-based insurance cost growth report found premiums for single health insurance policies slowed down post-ACA overall nationally, and specifically in 33 states and DC.
- However, the growth and proliferation of deductibles have impacted families, along with income growth that has failed to keep pace with insurance cost growth in many areas of the U.S.
While the Affordable Care Act's marketplace struggles and successes seem to get the bulk of discussion, the health law's impacts on the world of employer-based coverage affect far more people; as of 2015, 57% of people under 65 (154 million) were covered by an employer-provided health plan, compared to the 10 million people covered by marketplace plans, the report noted.
Given that, cost increase concerns from the employer-based plan demographic warrant investigation, and the Commonwealth Fund did just that by examining the latest data from the federal Medical Expenditure Panel Survey.
The results indicated premium increases had actually slowed since the ACA and deductibles have done the same but remain the bigger issue. "The number of employer plans requiring deductibles, as well as the size of those deductibles, has grown over the past decade," it found, adding deductibles for single-person plans increased 8.5% annually between 2010 and 2015, compared to 9.5% between 2006 and 2010.
Other research has previously pinpointed employer plan deductibles as a significant cost issue. A recent Kaiser/HRET survey concluded the rapid increase in deductibles has been a significant factor in allowing employer plans to slow down their premium increases to "historically low rates," while potentially impacting consumers' behavior and ability to pay.
Meanwhile, slow wage growth has contributed to people paying a higher share of their income to premiums. The report found total employee premium contributions for single and family plans to have accounted for 5.8% of median household income in 2015 compared to 4.2% in 2006.
In trying to reconcile the impacts of premium contributions and deductibles combined, the report concluded moderate-income families were at risk of spending 10.1% of their earnings on health insurance and healthcare in 2015, compared to 6.5% a decade before.