No Advantage to Drop Group Health Insurance Under PPACA

Truven Health Analytics’s report, “Modeling the Impact of ‘Pay or Play’ Strategies on Employer Health Costs,” found employers will bear a burden of as much as $17,269 per employee (roughly $9,000 more than they currently spend) to shift their benefits to federally subsidized coverage obtained through a federal exchange in 2014 rather than continuing existing group health plans.

If employers choose to eliminate group health without providing a subsidy to employees to obtain coverage through an exchange, then employer costs would fall to $2,000 per employee—the cost of fines imposed by the PPACA for not providing coverage to employees—but each employee would be responsible for paying an average $16,551 a year for health coverage in 2014. Because employers must provide market value in order to retain skilled workers, this cost differential should encourage most companies to continue offering group health benefits, Truven said.

“This research proves, once again, that when employers invest in the health and wellness of their employee populations, they end up spending less on health care,” said Raymond Fabius, M.D., chief medical officer at Truven Health Analytics. “Not only is eliminating group health coverage not cost efficient, it would have an enormous negative impact on an employer’s competitive market position and—eventually—on the well-being of its people.”’

The white paper examined insurance claims and wage data from 33 large employers with 933,000 employees.

The full report is available here.