Will the ACA cause employers to drop health insurance coverage?

As describe in this recent Health Affairs article, as of 2011, your likelihood of being offered health insurance looked like this:

Courtesy of Health Affairs.

How will the ACA affect the share of individuals who receive coverage (and what type of insurance coverage they receive). This table describes some of the consequences.

Courtesy of Health Affairs.

Popular reports indicate that many of these findings will likely be true. Trader Joe’s announced that it was dropping insurance coverage for its part-time employees.

What quantitative effect will the ACA have on health insurance level coverage? Experts from the Congressional Budget Office (CBO), RAND, the Urban Institute, the Lewin Group and the Centers for Medicare and Medicaid Services (CMS) make the following projections.

Courtesy of Health Affairs.

One issue that this article ignores is that employer may shift workers from full-time to part-time status to avoid penalties. Fast food companies such as Subway and Papa John’s are cutting worker hours to 29 per week to avoid these penalties. An NBC News survey also found that cutting worker hours is likely to happen.

Courtesy of Health Affairs.

If more and more individuals move to the Exchanges, the federal government outlays to fund the Exchange subsidies may grow extensively. Jay Bhattacharya and co-authors find the following in a 2013 Health Affairs article.

We found that federal outlays and revenues for health exchanges were quite sensitive to changes in current household contributions to insurance. Because the extent of employers’dropping coverage is uncertain, our results imply that federal obligations will vary greatly based on the health care decisions of individuals, employers, insurers, and the government.

Source:

• Thomas Buchmueller, Colleen Carey and Helen G. Levy. Will Employers Drop Health Insurance Coverage Because Of The Affordable Care Act? Health Aff September 2013 vol. 32 no. 9 1522-1530.
• Daniel R. Austin, Anna Luan, Louise L. Wang and Jay Bhattacharya. Small Increases To Employer Premiums Could Shift Millions Of People To The Exchanges And Add Billions To Federal Outlays. Health Aff September 2013 vol. 32 no. 9 1531-1537