A report released by the National Association of Health Underwriters demonstrates what those in the industry have already predicted: Americans depend on their employer for health insurance coverage.
And for the most part, NAHU says, employees are receiving a "high level of health benefits" from their employers.
According to the survey of more than 1,100 NAHU members specializing in providing health insurance coverage, people with employer-sponsored health plans already receive emergency care and hospital care under every health care plan. Follow-up care such as in-patient rehab, nursing facilities and hospice care are also covered by 97, 93 and 90 percent of small-group plans, respectively. Prenatal, delivery and infant care along with organ transplants and prescriptions are also covered by nearly every plan.
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"Employer-based health insurance coverage is the single largest pillar of the American health insurance system," NAHU CEO Janet Trautwein says. "We need to protect and preserve this system that already provides health coverage to more than 160 million Americans."
NAHU conducted the survey in response to efforts by the U.S. Department of Health and Human Services to implement the essential health benefits provisions of the Patient Protection and Affordable Care Act.
The PPACA EHB provisions require HHS to develop minimum benefit plan coverage standards, to keep plans from shortchanging enrolling or using skimpy benefits in some areas to scare off applicants with health problems.
The nonpartisan Institute of Medicine has encouraged regulators to make sure that coverage is comprehensive but also affordable. The more expansive the essential benefits package is, the more expensive insurance premiums will be. And pricier insurance will lead to reduced rates of coverage, as fewer people and businesses will have the means to pay for it.
"The emphasis on affordability is good news for employers, who have been struggling with rising health care costs," Trautwein says. "Over the last decade, the average employer-sponsored insurance premium has risen 113 percent. Federal policymakers should keep this in mind as they lay out the new essential benefits package. An overly expansive package could exacerbate these cost trends and make insurance less affordable. Or it could cause employers to stop offering health benefits to their workers altogether. Employers are already saddled with costs that have risen faster than either wages or inflation."
"As the IOM report makes clear, for many individuals, coverage that's exceedingly generous but unaffordable is equivalent to no coverage at all. We recommend that HHS look to current employer coverage as the benchmark for their essential benefits package."
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