Managed Care

Employer-Sponsored Insurance Stands Unsteadily After ACA

John Marcille

One of our regular departments in decades gone by was called “Employer Update,” and it looked at what was on the mind of health plans’ most important customers: the businesses that buy coverage for employees.

We sort of stumbled into employer-sponsored health insurance, didn’t we? Wage and price controls during World War II forced worker-starved businesses to dangle fringe benefits as a way to compete. After the war, President Truman said, in effect, now let’s do something permanent, which raised such a political stink that all parties backed away with a “This will do, for now.”

That was nearly 70 years ago. Our cover story is a timely “Employer Update” that reports on what may finally be (dipping, once again, into the World War II era for the phrase) “the end of the beginning” of employer-sponsored health care.

Contributing Editor John Carroll points out that the Affordable Care Act flashes like a neon exit sign for businesses wishing to turn their backs on a system that too few find satisfactory. Analysts at Standard & Poor’s pointed out that the ACA means companies can “radically redefine” their place in health care. The temptation to dump workers on state exchanges might be just too great.

Except, as many experts say, this is far from a sure thing. They can’t see how companies can “suddenly tear themselves out of a system that has been woven around the close bond they want to forge with their most highly valued — and paid — staffers.”

Fortune 500 companies are certainly standing pat. Brian Marcotte, MS, CEO of the National Business Group on Health, says that based on recent research, “most large employers are expected to continue coverage for the foreseeable future.”

Check back in 70 years?

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