From the Journals

Employer-provided insurance stable after ACA implementation


Concerns that Affordable Care Act (ACA) provisions implemented in 2014 would lead large numbers of employers to drop health insurance coverage appear to have been unfounded, according to a study published in the journal Health Affairs.

More than 95% of employers did not change their insurance coverage policy between 2013 and 2014: 46.4% offered coverage in 2013 and continued it in 2014 and 49.1% did not offer coverage either year. Of the 21,900 private-sector employers included in the analysis, 3.5% provided coverage in 2013 but not in 2014 and 1.1% did not offer it in 2013 but did in 2014, reported Jean Abraham, PhD, of the University of Minnesota, Minneapolis, and her associates (Health Aff. 2016 Oct 26;35[11]. doi: 10.1377/hlthaff.2016.0631).

Employer-sponsored health insurance, 2013 and 2014
The net change of –2.4% in employers offering health insurance – the 3.5% that dropped coverage combined with the 1.1% adding it – was more than the –1.3% average for the previous 3 years but less than the 2.8% drop between 2010 and 2011, “which suggests that our result was not an outlier,” the investigators noted.

The analysis of data from the 2014 Medical Expenditure Panel Survey–Insurance Component, however, did show associations between coverage changes and several workforce and employer characteristics. “Small firms were more likely to drop coverage compared to large ones, as were those with more low-wage workers compared to those with fewer such workers, newer establishments compared to older ones, and those in the service sector compared to those in blue- and white-collar industries,” Dr. Abraham and her associates wrote.

The Robert Wood Johnson Foundation’s State Health Access Reform Evaluation program supported the study. No other financial disclosures were provided.

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