Data Show Migration Away From Employer Health Plans

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Opponents of the Affordable Care Act (ACA) continue to call for its repeal, but it’s unclear what they want instead. A report in the new issue of The American Journal of Accountable Care finds that starting with the Great Recession, the exodus from employer-sponsored health plans and into Medicaid has reshaped healthcare, which makes eliminating the ACA difficult.

The American Journal of Accountable Care is a publication of The American Journal of Managed Care.

It can be hypothesized that the mandates and requirements of the ACA, as well as its offer of exchanges as alternatives to employer insurance, may have encouraged many employers to cancel their group insurance plans after 2010.

Group plans run by employers are fading as the centerpiece of health coverage, according to health insurer data presented in the new issue of The American Journal of Accountable Care, a publication of The American Journal of Managed Care. Instead, many more Americans are covered by Medicaid, which was gaining membership even before passage of the Affordable Care Act (ACA) in 2010.

In the article, “What US Health Insurers’ Data Show for ACA ‘Repealers,’” led by Etti G. Baranoff, PhD, of Virginia Commonwealth University, the authors show how trends that began with the Great Recession in 2008 have been cemented under the ACA, especially after the first open enrollment period on the Marketplace exchanges. These trends include:

  •     A move away from group health coverage, especially after 2013
  •     An increase in the number of Medicaid enrollees, with a rapid rise in physician encounters.
  •     Less steep enrollment increases in Medicare, and in individual plans

These trends are not unexpected at the start of a recession, as businesses failed and canceled health plans, thus sending new waves of eligible enrollees into Medicaid--even before the 2010 expanded coverage to those earning up to 138% of the poverty level in states that chose to embrace this tenet (now up to 31).

The authors found, however, that as the economy rebounded, group health plans did not return with jobs. “The ACA may or may not have enhanced the trends,” the authors wrote. “It can be hypothesized that the mandates and requirements of the ACA, as well as its offer of exchanges as alternatives to employer insurance, may have encouraged many employers to cancel their group insurance plans after 2010.”

About the Journals and AJMC.com

The American Journal of Managed Care is the leading peer-reviewed journal dedicated to issues in managed care. AJMC.com distributes healthcare news to leading stakeholders across a variety of platforms. Other titles in the franchise include The American Journal of Accountable Care, which publishes research and commentary on innovative healthcare delivery models facilitated by the 2010 Affordable Care Act. AJMC’s Evidence-Based series brings together stakeholder views from payers, providers, policymakers and pharmaceutical leaders in oncology and diabetes management. To order reprints of articles appearing in AJMC publications, please call (609) 716-7777, x 131.

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