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New Kaiser Survey on Employer Health Coverage Released

National Study on Employer Health CoverageNearly every September for the past two decades, I have released our survey findings from the Iowa Employer Benefits Study and, during that same month, would eagerly await the results from the annual Kaiser Family Foundation Employer Health Benefits Survey. The Kaiser findings put a complementary national perspective to our Iowa results.

Unfortunately, due to the Covid-19 pandemic, I pumped the brakes on surveying Iowa employers for this year. Kaiser, however, did pursue their national survey and it was released a little later than usual – on October 8.  The results provide an important glimpse into what is happening to employer-sponsored health insurance around the U.S.  Overall, Kaiser surveyed 1,765 non-federal public and private organizations with three or more employees, and from this number, 540 employers were located in 12 Midwestern states (an average of 45 employers per state). The Kaiser study, I must mention, does not break out the results by each state, only by region.

Key Findings by Kaiser

The Kaiser survey is very helpful because it documents national health trends for employer-sponsored plans. Some of the key findings in 2020 include the following:

  • About 56 percent of employers offer health benefits, a percentage that remains unchanged over the past five years. Similar to Iowa, the larger the employer, the more likely health benefits are offered. About half (53 percent) of U.S. organizations with fewer than 50 employees offer health coverage, and nearly all (99 percent) of the organizations surveyed by Kaiser with at least 200 employees offer health coverage.
  • The average single and family premiums increased by four percent over the past year, while worker’s wages increased by 3.4 percent and inflation increased by 2.1 percent.
  • The average annual premium for single health coverage is now $7,470, while the average family health premium is at $21,342. Over the last five years, the family premium has increased over 22 percent, and over the last 10 years, it has increased 55 percent.
  • On average, covered workers contribute 17 percent of the total single coverage premium and 27 percent of the premium for family coverage. In our 2019 Iowa study, we found that covered workers contributed 18.6 percent for single coverage while workers for family coverage contributed 30 percent of the premium.
  • The average single deductible found by Kaiser now stands at $1,644, which is remarkably similar to last year’s $1,655 average. In 2020, 83 percent of covered workers have a deductible in their plan, similar to last year.
  • Most large organizations (81 percent) offer at least one type of wellness or health promotion program. However, among those that offer the coverages, only 11 percent) view the programs as “very effective” at reducing the organization’s health care costs.
  • About 83 percent of surveyed employers who offer health benefits say they are satisfied with the overall choice of providers available through their insurance plans, however, only two-thirds (67 percent) say the same about their mental health and substance abuse networks.

The 2020 Kaiser survey was conducted from January to July, with about half of the interviews conducted before the full extent of the pandemic had been felt by surveyed employers.  Kaiser President and CEO Drew Altman acknowledged, “…our survey shows the burden of health costs on workers remain high, though not getting dramatically worse. Things may look different moving forward as employers grapple with the economic and health upheaval sparked by the pandemic.”

Because of this, next year’s survey will provide a more realistic look at how the pandemic may have impacted employer-sponsored health benefits in the U.S.

To learn more about the Kaiser study, the article was published in the peer-reviewed journal Health Affairs.

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Midterm Elections and Healthcare – The Consensus For Moving Forward Is…

The votes were cast and we now have a split in party control in both the House and Senate. What does this mean for healthcare as we now look toward the 2020 elections and beyond? Here are a few “bottom line” excerpts from various healthcare experts who follow the Washington political gridlock circus.

Drew Altman, President, Kaiser Family FoundationNovember 8 Blog

With a Democratic House, a Republican Senate, and President Trump in the White House, get ready for two years of maneuvering but little progress on health care – unless you look beyond Washington…Democratic control of the House stops any Republican efforts to revive their efforts to repeal and replace the Affordable Care Act, block grant Medicaid or impose a per capita cap on federal Medicaid spending…the same applies to any big changes Republicans might want to make to Medicare…the proposals made in Congress and the campaign are important because they can shape the agenda after 2020. But for now, the states are where the real action is.”

Merrill Goozner, Editor Emeritus of Modern HealthcareNovember 8 Editorial

“…Given the powerful special interests invested in preserving the status quo, the most likely scenario over the next two years is inaction on each of those issues (addressing root causes of high healthcare costs, universal healthcare, surprise bills for out-of-network charges, etc.). This year’s election offered no guidance toward a politically acceptable solution to healthcare’s core problem: its unacceptably high cost.”

Stephen Miller, Online Manager/Editor, Compensation & Benefits, Society For Human Resource Management (SHRM) – November 8 Article

Mr. Miller summarizes many thoughts from national pundits about the next two years in healthcare – much of this relates to the employer perspective on regulation. Miller writes:

“The partisan divide makes it unlikely that any major changes in the ACA will advance to the desk of President Donald Trump. That doesn’t mean bipartisan efforts to address health care challenges are off the table. Meanwhile, heading into the 2020 presidential election, progressives will continue to advocate for government-funded single-payer health care for everyone.”

The Commonwealth FundNovember 7 Analysis

“…efforts to repeal the ACA or make large-scale changes to programs like Medicaid are likely off the table, though the (Trump) administration is expected to continue to pursue actions to undermine key elements of the ACA. What we may see is congressional activity on two fronts: stabilizing the individual health insurance markets and controlling high drug prices…”

Robert Pearl, M.D., Contributor to ForbesNovember 7 Blog

Dr. Pearl finishes with a paragraph that summarizes nicely the many blogs that I have written over the past seven years:

“Looking ahead, don’t expect your healthcare to change (or improve) much over the next two years. That’s because we have confused the disease with the symptom. Rising healthcare premiums and excessive out-of-pocket expenses are not the real problem. They are the result of wasted effort, inefficiency and price-jacking among healthcare’s biggest players: drug companies, hospitals and specialists. Health insurance coverage is essential, but until we as a nation grapple with how care delivery is structured, reimbursed, technologically enabled and led, voters will remain concerned about costs, fearful of losing their coverage and confused about how best to improve healthcare in the future.”

These are just a few post-election prognostications about healthcare’s uncertain road to reform. As we know from past observation, gridlock will continue and states will work diligently to find their own solutions to both access ‘quality healthcare’ and identify cost issues.

With a special thanks to Dr. Pearl (again) from his November 2 piece in the Los Angeles Times, the following quote is most appropriate for healthcare and how it usually fares in our national and local elections:

Campaign promises are like babies: easy to make, but hard to deliver.

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