Provision in Obamacare Likely to Force Up Cost of Many Family Plans

In an ongoing trend, unrelated to Obamacare, companies have been passing on more and more healthcare costs to employees.

However, an ACA gotcha has impacted the way costs are passed on, with families taking a bigger hit than individuals at many companies.

Please consider Companies Prepare to Pass More Health Costs to Workers.

Many employers are betting that the Affordable Care Act's requirement that all Americans have health insurance starting in 2014 will bring more people into their plans who have previously opted out. That, along with other rising expenses, is prompting companies to raise workers' premium contributions, steer them toward high-deductible plans and charge them more to cover family members.

The changes as companies roll out their health plans for 2014 aren't solely the result of the ACA. Employers have been pushing more of the cost of providing health insurance on to their workers for years, and firms that aren't booking much sales growth due to the sluggish economy are under heavy pressure to keep expenses down.

A quirk of the Affordable Care Act could make it more appealing for companies to raise rates for family coverage than for individuals, said Vivian Ho, a Rice University health-care economist.

Starting in 2015, companies employing 50 or more people must offer affordable health-care coverage to anyone working 30 hours a week or more. But affordability is measured using the cost of individual coverage, capping the cost at 9.5% of income, Ms. Ho said. Raising family rates could help companies recoup costs without running afoul of that limit, she said.

Gannett Co., which owns more than 80 newspapers and 23 television stations, expects one factor in its increased health costs to be the addition of more employees to its insurance plans due to the ACA rules, according to a person familiar with the company's projections.

To address an overall increase in costs, Gannett has replaced the two plans for families it used to offer its workers with a single high-deductible plan that requires employees to pay the first $3,000 of medical costs each year, according to workers at the Indianapolis Star, one of the company's papers. For those with individual coverage, who make up a little over half of Gannett's insurance pool, the figure is $1,500.

The company also scrapped a sliding scale that let lower-income workers pay lower premiums. For some employees, the result was a 60% jump in monthly premiums for family coverage, to $575 from about $360.

Gannett said more than half of its employees will see premiums fall by 12%.

United Parcel Service Inc. made headlines in August when it said that it would bar spouses from its nonunion health plan if they could get coverage at their own jobs. The company said it expected to see an increase in its health-care costs in part from adding employees to its plan who currently opt out.

About 6% of employers ban coverage for spouses who can get it elsewhere, and another 6% impose an explicit surcharge for covering a spouse, according to Mercer. American Electric Power Co., for example, began imposing a $50 monthly surcharge this year to cover spouses with access to insurance at their own workplace. AEP said 92% of its employees usually sign up for coverage, so it doesn't expect a surge of new enrollment.

In another shift this year, companies have become increasingly aggressive about steering employees toward plans in which they pay more of the initial costs for their care in exchange for lower premiums.

Trucking and logistics company Ryder System Inc. has replaced one of its two insurance options with one such high-deductible plan. Ryder is encouraging employees to choose the new option in part by raising the cost of more traditional coverage.

Winners and Losers

Half of Gannett employees will see a 12% drop in premiums. But others will see a 60% rise. And for those who do see premiums decline, the drop will be solely because they are forced into high deductible plans.

Obamacare created a pool of winners and losers, with some of the losers far worse off than before. Many people were hardly affected at all, at least initially. In aggregate, ACA did nothing to lower overall costs, it just shifted costs around in an inefficient manner, making things worse than before. 

The most widely reported "success" has been the enrollment of tens of thousands of people into Medicaid. Because of cost sharing that kicks in later, many states are likely to regret that effort.

Mike "Mish" Shedlock
http://globaleconomicanalysis.blogspot.com