Employer-sponsored health care is at a crossroads, with myriad financial challenges, legal uncertainties and the result of the 2012 election weighing heavily on company decisions about healthcare benefits, according to a new Deloitte issue brief.
For one thing, there's the possibility Republicans could win elections to Congress and the White House and could repeal all or parts of the Affordable Care Act, including the dozens of provisions large companies are already adapting to.
For another, there's rising healthcare costs and an aging workforce, which in a lot of cases, according to Deloitte, are compelling "employers either to pay an ever-increasing share of total compensation in the form of health care benefits or to reduce benefits."
All costs and regulations considered, some experts are wondering if employers' role in health insurance will decline in the near future.
By some measures, it's already happening. Between 2000 and 2010, the number of Americans insured through their employer fell by 9 million, while the total population grew by 33 million.
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Still, 68 percent of civilian workers in the U.S. were covered by their employer in 2010, and among older workers, it remains popular. Nearly 8 in 10 older consumers surveyed by Deloitte said they or their spouse's employer-sponsored insurance is a major reason why they stay with the employer.
But consumer satisfaction differs little between employer-sponsored and individual plans. In Deloitte's 2011 healthcare survey, 49 percent of consumers insured through their employers reported satisfaction with their health plan, compared with 53 percent of consumers with individual insurance.
Considering rising healthcare costs and the costs of compliance with the Affordable Care Act, employers have a lot of decisions to make, although their options will be governed by a number of ACA provisions. The option of consumer driven health plans, for instance, will be somewhat limited under the ACA.
As Deloitte notes, there is the option of eliminating healthcare coverage and taking the $2,000 per-employee penalty. But before doing that, Deloitte recommends a cost/benefit analsysis, considering how it might affect workplace morale, retention and recruitment, and what would be needed to compenstate with higher wages.
On the other hand, there may be some room for employers to try new approaches to benefits, such as "employer coalitions" that use scale to directly buy healthcare services from providers, and the "defined contribution approach," where the employer's and employee's contribution to the plan is fixed as a percentage of the premium.