SURVEY SAYS – What Will Health Care Reform Look Like?

May 27, 2009 ( - Many say the time is "right" for health care reform.

In fact, President Obama has said “health care reform cannot wait, it must not wait, and it will not wait another year.”    Of course, the devil is (always) in the details, and, in the interests of achieving that goal, there seems to be some willingness to “give” on the campaign trail promise that “if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year.”   That said, there have been a number of other possible results tossed out.  

This week I asked readers, to opine on what health care reform might look like – if it passes this year.   The answers, while varied, don’t bode well for those employers who currently offer health care coverage – or the workers that currently enjoy that benefit.  

In posing the question, I presented readers with the opportunity to respond on three separate aspects; the cost impact on employers, the impact (if any) on the tie between employment and health care benefits, and the cost for workers who had coverage today.

More or Less?  

On the first point, a clear plurality ( 39.6% ) thought that reform would mean that employers would pay more than they do at present – as one reader noted, “It’s simple economics. There will be more services provided to more people. It’s going to cost more. I do not expect to pay any less than I do today. I expect I and everyone else will pay more.”  So far, so good – but that same reader went on to note, “What I’m hoping (although my hopes grow dimmer by the day) is that we don’t get ripped off like the bondholders for Chrysler because we are less favored than some other group of people. I’m expecting a large swath of people and companies to get ripped off. This can be through paying more and also through receiving less in services, through waiting in lines, getting prioritized at the back of the line, etc.”

However, nearly as many ( 34% ) said that “some would pay more, others less.”   One reader said, acknowledging the President’s campaign trail statement, “Maybe your costs will go down $2500 per year but your increase in income taxes will more than offset the lower costs ”   Another noted, “Probably some kind of a cap on tax-favorable treatments or elimination of certain tax-advantage programs to help pay for the reform.”  

A full one-in-five said “who knows?” (as one reader observed, “The question sounds like my economics class, “assume away the world as we know it, then what will happen?”. Too many variables to know the result”, while another noted, “Depends. If there are other options for employees, some small to medium size employers may elect to get out of the business of providing health care coverage all together. It’s really to early to tell because the outcome will dictate our actions.” ), and only about 6% thought that employers would pay less.   Not a single respondent thought there would be no change in how much employers paid.

As for the impact on workers who currently enjoy health care benefits, more than half - 60.7% - said that those workers will pay more if health care reform happens this year.   Roughly a quarter ( 23.2% ) thought that workers would pay the same, "but perhaps in different ways," while just half that number ( 12.5% ) believed that workers would pay the same as they do today for that coverage.   Perhaps most telling - a mere 3.6% thought that workers who have health-care coverage today would pay less.

As for that tie between the workplace and employer-sponsored health-care, nearly half ( 47.3% ) of this week's respondents said that employers would be forced to offer health-care benefits, while nearly as many ( 38.2% ) thought that health-care reform would mean that employers would be less likely to offer those benefits, including the reader who noted, "If they do away with the tax exclusion for employers to offer health insurance to their employees, they will not have as much of an incentive to offer healthcare. For the employer, it may be cheaper to go with the new public plan that is outlined in the individual proposals."  A mere 10.9% thought there would be no difference from how the benefit is available today, and even fewer - 3.6% - said that employers would be more likely to offer health-care benefits as a result.

As one noted, "In light of current economic conditions, employers are cutting back benefits left and right in the name of expense management. Unemployment is high, there are multiple workers for every open position. Employers have no incentive to beef up or even maintain current benefits for employees, they do not need it to recruit people. If the legislation that comes out of health care reform includes ways for everyone (employed, underemployed, unemployed) to get health care insurance directly from their state or the federal government, you will see employers back away from offering it to employees. And the subsidy they were providing will be eliminated. The entire cost of insurance will be coming from individuals."

One reader observed, "Somehow they are going to kill employer-provided health care. It will go the way of the DB plan."   In fact, the verbatims this week seemed to largely range from negative - to resigned, with only a handful it seemed optimistic about the benefits of reform for those who already enjoy workplace coverage.

"The government needs to stay out of it. They will just end up costing employees our employer sponsored health coverage. Just like section 89 cost us our retirement health coverage."

"Something has to give to pay for the care for the uninsured or uninsurable. Don't hold your breath waiting for the insurance industry to kick in any help."

"The simple math here is that a benefit costs money. If more people will be provided a benefit, it has to be paid for by someone. That means you as a consumer, you as an employee, or you as a taxpayer. So that means you."

But this week's Editor's Choice goes to the reader who noted, "Hopefully the incentive for offering group health coverage will not be destroyed, because if Congress really thinks that employers (with the exception of perhaps large ones) will pay part of it without getting a tax break, they must have moved to Oz."

Thanks to everyone who participated in our survey!