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Think tank says small-group market is still alive

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U.S. residents who work for small employers may have more access to employer-sponsored health benefits now than they did three years ago.

Frederic Blavin and other analysts at the Washington, D.C.-based Urban Institute have presented data supporting that conclusion in a new summary of worker survey results. 

The analysts looked at responses from adults ages 18 to 64 who participated in the Urban Institute’s Health Reform Monitoring Survey from 2013 through March. The analysts classified participants as “workers” if the participants said they were working for pay or were self-employed.

The analysts classified the participants as working for small employers if the participants said their employers had fewer than 50 employees.

Major Affordable Care Act product design rules and underwriting rules took effect in the U.S. group health market in January 2014.

The Urban Institute analysts found that 62 percent of all small-employer workers reported receiving an offer of health coverage in March, up from 60.9 percent in June 2013.

Related: High-income uninsured people: 4.4 million are still out there

The percentage of large-employer workers who reported receiving offers of coverage stood at 94.1 percent, up slightly from 94 percent in June 2013.

For small-employer workers with family income under 250 percent of the federal poverty level, the coverage offer rate jumped to 44.9 percent over that period, from 42.6 percent. For large-employer workers with low family income, the coverage offer rate increased to 83.4 percent, from 82.7 percent.

Results differ from another study

In the higher-income category, the small-employer coverage offer rate crept up to 80.4 percent, from 80.1 percent. In that higher-income category, large-employer coverage offer rate fell slightly: to 98.6 percent, from 98.7 percent. 

“We found no evidence that [employer-sponsored insurance] offer, take-up and coverage rates fell,” the analysts write.

The Affordable Care Act imposes tax penalties on many taxpayers who lack what the government defines as adequate coverage, and that may have increased financial incentives for employers to offer coverage and for workers to take up the coverage, the analysts say.

Last week, analysts at another organization, Mark Farrah Associates, reported that insurers reported a 25 percent drop in the number of small-employer group plans they provide, and a 19 percent drop in the number of people the small-employer plans cover, between 2013 and 2015.

Related: Insured small-group plan count drops 25% in two years

The Mark Farrah analysts noted that their study may leave out small employers that are self-insuring, rather than using fully insured health coverage.

The Urban Institute analysts also used a different definition of “small employer” than the insurer filings used in the Mark Farrah study.

The Mark Farrah definition of “small employer” includes employers with five to 100 employees.


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