Reports show the way Americans receive and pay for health insurance has been changing for more than 10 years

September 25, 2013 | Publication

The Center for Healthcare Research & Transformation (CHRT) today released two briefs showing that for more than a decade, employers have been dropping health insurance and consumers have been paying more out-of-pocket for health care, a trend that began many years before the development of the Affordable Care Act. The research briefs also show Michigan’s employers are increasing employee cost-sharing and moving to high deductible health plans at a faster rate than the national average.

According to the data, from 1999 to 2011, the proportion of individuals covered by employer-sponsored insurance decreased by approximately 15 percent nationwide. Between 2008 and 2011 specifically, the proportion of people with private health insurance (either through their employers or individually-purchased) fell 4.7 percent in Michigan and 4.4 percent nationwide.

“Many people are concerned that employers will drop employee health insurance as the Affordable Care Act fully kicks-in, but the fact is, this has been happening for many years already,” says Marianne Udow-Phillips, director of CHRT. “Actually, the Affordable Care Act has some provisions that help those employees buy their own health insurance, if they lose coverage through their employer.”

The briefs also track the rise of employee cost-sharing and high-deductible health plans from 2002 to 2012, showing a higher trend in Michigan. Large employers increased the employee-share of premiums payment for family coverage by about 17 percent across the US, but in Michigan, that employee-share rose 52 percent. In small firms, employee-share of premium payment for family coverage rose 10 percent nationally, but 50 percent in Michigan. Despite this marked increase in Michigan, average cost-sharing for employees in Michigan was still somewhat below the national average because Michigan employers historically offered plans with much lower cost-sharing than other employers nationally.

Other findings include:

• From 2002 to 2012, the number of employees with some form of a deductible requirement increased 67 percent nationally and 100 percent in Michigan.

• The average deductible amount for family coverage in Michigan rose from $810 in 2002 to $1,877 in 2012.

• In Michigan, roughly 55,000 low-income people age 18–25 gained or retained private health insurance from 2010 to 2011, as a result of the Affordable Care Act.

“The bottom line is, consumers have been paying more for health coverage and employers have been dropping health coverage, for more than a decade. These trends are happening independent of the Affordable Care Act,” says Udow-Phillips. “Assuming these trends continue, the ACA does offer some options that did not exist before. Many who have lost health coverage will be eligible for tax credits to help pay for health insurance in the Marketplace. And we’ve already seen more young adults obtain coverage by staying on their parents’ plans.”

The research briefs, Employee Cost-Sharing for Health Insurance in Michigan and Private Health Insurance in Michigan, 2008 to 2011, are part of Cover Michigan 2013, a series of publications tracking trends in access to care, cost and quality in Michigan. Copies of the research briefs are available at chrt.test.