Nationwide Coverage Is Changing, And It’s Not All Because of the ACA
February 16, 2016
Ever wonder why businesses provide health insurance to their employees? Historically,
it has not been required by law. Undoubtedly, employers do so for more than one reason.
Most would acknowledge the desire to keep their employees healthy, both physically
and fiscally, as one of the bigger reasons.
Perhaps an even greater reason is that providing insurance has become pretty much
essential if an employer is going to recruit and retain employees. An exception to
this rule is the business that has no problem in recruiting and retaining employees
and that business is usually one that pays lower wages. Two other major reasons why
companies offer health insurance are that it is tax deductible to the business, and
employees pay no taxes on the benefit.
Federal government initiated these tax incentives in the early 1940s, and by the mid-1960s,
employer-sponsored health benefits were the norm. Today, about 160 million Americans
are covered by their employers’ plans. So, even before the passage of the Affordable
Care Act (ACA), which places demands on employers with 50 or more full-time equivalent
workers (FTEs), companies have been a critical factor in Americans’ health care coverage.
Companies with 50 or more FTEs still have a choice to provide health insurance or
pay a fine, just as individuals do. Some companies, like individuals, elect to pay
the fine because the penalty is less than the cost of health insurance. The decision
often comes down to cost. However, as fines increase, this is subject to change.
Some recent articles show some employers that have always provided health insurance
are considering opting out of health insurance and directing employees to a private
exchange to purchase insurance. In doing so, they would provide a defined contribution
compared to a defined benefit, as is current the normal case. The ACA’s combination
of tax subsidies and a new non-group insurance have made privately purchased a better
deal for some employees. For some employers, dropping health insurance and increasing
wages to a degree is preferable to paying hard-to-manage health insurance costs. Employers
are considering using premium reimbursement plans, such as Section 105 Health Reimbursement
Plans, to cover the cost of employees’ individual health insurance. This approach
is a cost-effective way to offer employee health benefits. Experts predict that 60
percent of small businesses will adopt individual health insurance and premium reimbursement
solutions by 2017.
Getting good people to come to work for a company is always a challenge, especially
with a low unemployment rate. Therefore, my hunch is employer-sponsored plans will
be with us for a long time because the company that creates the least hassle in getting
health insurance for its employees will have an advantage in the labor market.