U.S. group health plans may be losing market share in spite of employer efforts to maintain and improve health benefits packages.
Joelle Abramowitz, an analyst at the Census Bureau, has published data supporting that possibility in a comparison of bureau Current Population Survey data from March 2014 and March 2015.
Abramowitz looked at survey data on the percentage of workers who said they were offered group health benefits, the percentage who found they qualified to sign up for benefits, and the percentage who took up the benefits offered.
Abramowitz also looked at data on workers’ reasons for refusing to take up group health benefits.
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Originally, the 2010 Patient Protection and Affordable Care Act (ACA)of was supposed to require large employers to offer group health benefits, or else pay a penalty, starting in January 2014. Regulators put off enforcement of the employer “shared responsibility” penalty. The U.S. Department of Health and Human Services and the Internal Revenue Service are just now getting ready to impose penalties.
The ACA was also supposed to set up a small-group equivalent of the ACA public health insurance exchange. Public exchanges do operate Small Business Health Options Program divisions in most states, but overall sales appear to be low. The Obama administration has never published comprehensive small-group exchange enrollment figures.
Federal Bureau of Labor Statistics surveys show little change in private-sector group medical coverage offer and take-up rates between 2014 and 2015.
The Menlo Park, California-based Henry J. Kaiser Family Foundation has published survey data of its own suggesting that the percentage of firms with 200 or fewer employees offering health coverage may have fallen to 45 percent in 2015, from 47 percent in 2013, while the percentage of larger firms offering coverage may have increased to 63 percent, from 62 percent, over that period.
The McMurray, Pennsylvania-based Mark Farrah Associates has reported that enrollment in fully insured large-employer plans appears to have fallen 12.5 percent between 2013 and 2015, and that enrollment in small-group health insurance plans has fallen about 20 percent over that same period.
For a look at what Abramowitz found when she looked at worker survey data, read on:
A healthier economy and publicity about the ACA may have helped boost employer health coverage offer rates in 2015.
1. Employers were more likely to offer the workers group health coverage in 2015.
The percentage of all surveyed workers who said they were offered employer-sponsored health coverage increased to 78.8 percent in 2015, from 78.3 percent a year earlier.
The coverage offer rate increased to 58.6 percent at firms with fewer than 100 employees, and to 91.1 percent, from 90.4 percent, at larger firms.
The offer fell to 82.7 percent, from 82.9 percent, for workers ages 46 and older, but it increased to 64.4 percent, from 62.3 percent, for workers ages 15 to 25, and to 80.3 percent, from 79.8 percent, for workers ages 26 to 45.
Waiting periods and other plan features kept fewer workers out of their employers’ health plans in 2015. (Photo: Allison Bell/LHP)