The Patient Protection and Affordable Care Act of 2010 (PPACA) is starting to have noticeable effects on group health coverage, researchers say.

The researchers, at the Henry J. Kaiser Family Foundation, Menlo Park, Calif., and the Health Research & Educational Trust, Washington, have reported that finding in a report based on a survey of 2,088 U.S. employers.

The researchers found that the overall percentage of participating employers offering health benefits fell to 60% this year, from 69% in 2010, with the offered rate holding steady at about 99% for firms with 200 or more workers, dropping to 59%, from 69%, for firms with 3 to 199 workers, and sinking to 48%, from 59%, for firms with 3 to 9 workers.

The average annual single premium increased 8%, to $5,429, and the average annual family premium increased 9%, to $15,073.

The researchers also found that the shift to high-deductible plans is continuing, with 17% of covered workers now in high-deductible plans, with or without access to special savings accounts, up from 13% in 2010.

About 55% of covered workers are in preferred provider organization plans (PPO) not officially classified as high-deductible plans, 17% are in health maintenance organization plans, 10% are in point-of-service plans, and just 1% are in traditional indemnity plans,

About 21% of workers in ordinary PPO plans now have deductibles of $1,000 or higher, even though, technically, they are not classified as being in high-deductible plans, researchers say.

When the researchers asked about the effects of PPACA provisions that have already taken effect, the found that:

  • About 15% of firms with 3 to 49 employees and no health coverage have considered adding health insurance because of the existence of a new PPACA small business tax credit.
  • About 20% of all firms, and about 70% of large firms, said they have enrolled at least one additional adult child because of the PPACA provision that requires large and midsize group plans to offer workers access to dependent to coverage up to age 26. The average number of adult dependents enrolled as a result of the provision is 6 at all firms affected by the change, 10 and firms with 200 to 999 workers, and 492 and firms with 5,000 or more workers.
  • About 23% of all plans, and 28% of plans with 200 or more workers, said they have changed preventive care copayment or coinsurance rules because of a PPACA provision that requires non-grandfathered plans with 200 or more workers to provide first-dollar preventive care services coverage.

The researchers did not try to estimate how much PPACA-related coverage additions and improvements have cost or provide an estimate of coverage losses resulting from PPACA.

Karen Ignagni, president of America’s Health Insurance Plans (AHIP), Washington, says policymakers should see the health cost figures in the report as the latest warning that far more needs to be done to address the rising cost of health care.

“Policymakers in Washington and the states need to focus on all of the factors that are driving premium increases: Soaring prices for medical services, changes in the covered population that has resulted in an older and sicker risk pool, and new benefit and coverage mandates that add to the cost of insurance,” Ignagni says. “Reducing health care cost growth will make it easier for consumers and employers to afford coverage, ease the burden on federal and state budgets, and put our vital safety net programs on sustainable and fiscally responsible paths.”

- Allison Bell

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