The Affordable Care Act, which requires most Americans to have health insurance or pay a fine next year, is likely to increase the number of workers who get job-based coverage.
“This will be an important issue to watch next year, as employers will have more flexibility and could ask workers to pay more because of their lifestyles and health conditions,” said Kaiser Vice President Gary Claxton.
Along with a slowdown in consumer spending for health care because of the economic recession, many feel provisions of the Affordable Care Act are helping to moderate premium growth. In particular, Altman cited the law’s so-called “80/20” rule, which penalizes insurers for spending less than 80 percent of premium revenue on medical care or quality improvements.
He said the provision has caused insurers to put more pressure on health care providers to keep costs down.
The percentage of workers enrolled in “grandfathered” health plans, which are exempt from many provisions of the health care law, fell to 36 percent in 2013, from 48 percent in 2012 and 56 percent in 2011.
Other major findings:
– Preferred Provider Organizations, known as PPOs, remain the most popular job-based health plans, enrolling 57 percent of covered workers in 2013. Twenty percent are enrolled in high-deductible health plans, 14 percent in health maintenance organizations, or HMOs, 9 percent in point-of-service plans, and less than 1 percent are in conventional plans.
– 78 percent of workers face an annual deductible, up from 72 percent last year.
– 38 percent of all covered workers face a large deductible of at least $1,000 or more. For workers at small firms, the share is 58 percent.
– 29 percent of jumbo firms – those with at least 5,000 workers – are considering offering coverage through a private exchange in the future. Private exchanges are a somewhat new concept that offer a wide range of plans for employees at participating companies to choose from.