Blavin Fredric, Shartzer Adele, Long Sharon K, Holahan John
Fredric Blavin (
Adele Shartzer is a research associate in the Health Policy Center, Urban Institute.
Health Aff (Millwood). 2015 Jan;34(1):170-7. doi: 10.1377/hlthaff.2014.1298.
Critics frequently characterize the Affordable Care Act (ACA) as a threat to the survival of employer-sponsored insurance. The Medicaid expansion and Marketplace subsidies could adversely affect employers' incentives to offer health insurance and workers' incentives to take up such offers. This article takes advantage of timely data from the Health Reform Monitoring Survey for June 2013 through September 2014 to examine, from the perspective of workers, early changes in offer, take-up, and coverage rates for employer-sponsored insurance under the ACA. We found no evidence that any of these rates have declined under the ACA. They have, in fact, remained constant: around 82 percent, 86 percent, and 71 percent, respectively, for all workers and around 63 percent, 71 percent, and 45 percent, respectively, for low-income workers. To date, the ACA has had no effect on employer coverage. Economic incentives for workers to obtain coverage from employers remain strong.
批评者常常将《平价医疗法案》(ACA)描述为对雇主提供的保险存续的一种威胁。医疗补助计划的扩大以及医保市场补贴可能会对雇主提供医疗保险的动机以及员工接受此类保险的动机产生不利影响。本文利用了2013年6月至2014年9月期间《医疗改革监测调查》的及时数据,从员工的角度审视了《平价医疗法案》实施后雇主提供的保险在提供率、参保率和覆盖率方面的早期变化。我们没有发现证据表明这些比率在《平价医疗法案》实施后有所下降。事实上,它们一直保持稳定:所有员工的这三个比率分别约为82%、86%和71%,低收入员工的这三个比率分别约为63%、71%和45%。到目前为止,《平价医疗法案》对雇主提供的保险覆盖范围没有影响。员工从雇主那里获得保险覆盖的经济激励仍然很强。