More evidence is pouring in that underscores employers' commitment to providing health insurance to workers, despite having such options as the public and private insurance exchanges.

The publication Health Affairs reported that an analysis of data from June 2013 through September 2014 of worker-reported offer, take-up and coverage rates for employer-sponsored insurance plans showed no significant change in any of those measures during the 16-month study period. The data was provided by the Health Reform Monitoring Survey.

The numbers for all workers, which were essentially unchanged during the study period:

  • 82 percent offer rate;
  • 86 percent take-up rate;
  • 71 percent coverage rate.

For low-income workers, the numbers were lower but still did not vary significantly during the period. The study was done by four Urban Institute researchers.

Recommended For You

"To date, the ACA has had no effect on employer coverage. Economic incentives for workers to obtain coverage from employers remain strong," the researchers reported.

Pointing to other academic research, the authors said a combination of tax advantages and avoidance of PPACA penalties are working together to support the continuation of coverage — even among smaller firms that don't face the stringent regulations and sanctions that larger firms must confront.

"Abraham and coauthors [from the National Institute of Health Care Reform] estimate that employers of the vast majority of workers now offered employer-sponsored insurance will continue to have an economic incentive to offer coverage under the ACA," the researchers wrote.

"The largest firms will continue to have a strong incentive to do so because the large benefit of the employer coverage tax exclusion and penalties avoided by offering coverage greatly outweigh the value of the premium subsidies that workers would receive if their employers did not offer coverage. Firms with fewer than 50 workers will face significantly lower economic incentives to offer coverage because they employ a larger share of low-income workers and are not subject to the employer mandate. However, Abraham and coauthors estimate that most small firms that already offer coverage are likely to continue to do so."

Most earlier studies that have queried employers about their plans for continuing to offer coverage to the workforce have found a solid preference for doing so.

While offering coverage as a recruiting and retention strategy is usually cited as the main driver behind the strong trend found at major corporations, other factors may also be at work.

One may be a fear of offloading folks to the public exchanges before those exchanges have proven they could provide quality, affordable coverage.  A Towers Watson survey in September found that 99.5 percent of employers who participated in the survey said they would not move employees over to the public exchange system for health coverage, and three-quarters said they didn't think public exchanges would be a viable alternative for employee health insurance for at least the next two years.

Another factor could be the Internal Revenue Services' ruling last spring regarding employer payment plans. Essentially, under such a plan, an employer would set aside dollars to use to reimburse employees for coverage obtained from a public exchange. Some believed this arrangement would satisfy the guidelines for the employer's responsibility to provide coverage or pay a fine, as set out in the Patient Protection and Affordable Care Act. The IRS said such plans don't meet the guidelines and would result in substantial fines for employers.

Additionally, consultants have advised corporations that offloading workers to alternative insurance formats could deprive them of valuable health data about their workforce.

NOT FOR REPRINT

© 2025 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.

Dan Cook

Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.