Avalere: Cool Kids Could Throw Off Group Health Forecasts

The Patient Protection and Affordable Care Act (PPACA) should not have a dramatic effect on the employer-sponsored insurance market – unless it does.

Analysts at Avalere Health L.L.C., Washington, a health policy strategy firm, have included that warning at the end of a presentation on the effects of possible effects of PPACA on the group health market.

The analysts reviewed existing statistical analyses and used other methods to predict how the federal legislative package might affect employers in 2014, when employers will face a choice between offering health coverage that meets federal standards or paying a penalty and sending employees out to buy their own coverage on a guaranteed-issue, mostly community-rated basis through a new health insurance exchange distribution system.

Typical group health experts that have conducted simulations are predicting that PPACA could cause a change in group health enrollment ranging from 4.5% shrinkage to 9% growth, the Avalere analysts say.

Firms with a higher share of workers who place a high value on health benefits and have little opportunity to qualify for the new federal health insurance purchase tax subsidies seem more likely to continue to offer coverage, the Avalere analysts say.

Firms with a large percentage of younger, lower-paid, healthier workers who place little value on health benefits or are likely to qualify for health insurance purchase subsidies may be more likely to drop coverage, the analysts say.