The Robert Wood Johnson Foundation and State Health Access Data Assistance Center released a report finding that 60% of all insured Americans receive insurance through their work. This percentage is down from 70% in 2000, indicating a difference of 11.5 million individuals. The study notes that the decrease in receipt of employer coverage began prior to the 2010 implementation of the Affordable Care Act (ACA), and is caused by a combination of employers no longer offering coverage and employees no longer accepting it. Rising insurance costs is identified as the culprit responsible for the decline of employer-based health insurance.

A Congressional Research Service (CRS) report released last week clarified confusion associated with how companies treat their part-time and seasonal workers, and how this treatment may make them eligible for employer penalties under the Affordable Care Act (ACA). The CRS report includes updated information on employer penalties, which was provided by IRS guidance released late last year. According to the ACA, employers with a minimum of 50 full-time equivalent employees must offer affordable and adequate health insurance to their employees, or run the risk of receiving significant penalties under the law. The confusion on the issue stems from the difference in calculating which businesses are subject to penalties, and the IRS guidance helps to clarify this issue by explaining the ACA's classification of a full-time employee and provisions related to seasonal workers.

According to a new study for the National Institute for Health Care Reform (NIHCR), offering employer-sponsored health insurance will continue to make fiscal sense for businesses employing most workers (81%) now offered insurance. The study found that the economic incentives to offer coverage will remain strong under the Affordable Care Act (ACA) for most larger, higher-wage firms,  but will weaken for small and low-wage employers. These smaller firms are the companies already more likely to drop coverage to due rising costs. Pre-ACA, all businesses had the option to offer health insurance coverage. After 2014, employer premium contributions remain tax exempt, and two new policies will take effect. First,  larger employers that do not offer affordable health insurance will be penalized and second, premium tax credits for lower-income people to purchase insurance in new state exchanges if they lack access to affordable employer coverage will be available. The economic incentive to cover employees is calculated by adding the dollar value of the employer-sponsored insurance tax subsidy and the value of avoiding the penalty for not offering insurance, and then subtracting the value of the premium tax credits that eligible workers could use in an exchange if their employer does not offer coverage. After 2014, the largest firms (500 or more workers) will continue to have a strong economic incentive, with an average incentive of $2,503 per employee. However, the smallest firms (fewer than 50 workers) will face lower economic incentives because they are exempt from the penalty. Certain industries, such as food service, entertainment, agriculture, forestry and fishing, will have less incentive to offer employer coverage, as their workers will be eligible for exchange subsidies. The study draws on data from the 2008-2010 Medical Expenditure Panel Survey.

The Government Accountability Office (GAO) released a report yesterday which reviews estimates of the impact of the Affordable Care Act (ACA) on employer-sponsored coverage. According to some researchers, the ACA's Medicaid expansion and subsidized coverage for low- and moderate-income people who buy health insurance through Exchanges beginning may discourage employers from offering coverage. However, other researchers believe that the financial penalties imposed by the ACA will actually encourage employers to offer coverage. The GAO report examines 27 studies published between January 1, 2009 and March 30, 2012 that offer estimates regarding changes in employer-sponsored health coverage as a result of the ACA.

According to a new Gallup survey, fewer Americans got their health insurance from an employer in 2011 (44.6%) than in 2010 (45.8%), continuing the downward trend Gallup and Healthways have documented since 2008. As employer-based health insurance has declined, the percentage of Americans who are uninsured has increased, rising to 17.1% this year, the highest seen since 2008. The 25.2% of Americans who had government health insurance (Medicare, Medicaid, or military/veterans' benefits) has not changed since 2010. Two factors appear responsible for the increase in uninsured...

A new paper authored by researchers from the Urban Institute and funded by the Robert Wood Johnson Foundation examines how the Affordable Care Act (ACA) affects employer-sponsored insurance. The paper, "Employer-Sponsored Insurance under Health Reform: Reports of Its Demise Are Premature," finds that the ACA will have little overall effect on employer-based health coverage.