Majority of U.S. Workers Believe ACA Will Increase Health Insurance Premiums: NBGH

Despite an overall lack of familiarity with the Patient Protection and Affordable Care Act (ACA), the majority of U.S. workers believe the health care reform law will ultimately increase how much they pay for health care insurance over the next several years, according to research from the National Business Group on Health (NBGH). The survey, Employer Perspectives on the Future of Health Benefits and Health Care Delivery, also found an increasing number of employees who are confident in their ability to shop for health insurance on their own, and that many workers would use a private health insurance exchange to buy insurance if offered by their employer.

NBGH found that 54 percent of respondents believe that their health insurance premiums will rise over the next 12 months because of the ACA, and 56 percent expect costs to jump over the next three to five years. Additionally, 32 percent believe that the quality of their health care benefits will decline over the next three to five years. Just 15 percent think they will not be able to afford coverage through their employer or union over the next three to five years, and only 10 percent believe their employer or union will not offer coverage in the future.

According to the survey, only four in ten respondents are familiar with the ACA itself, although respondents are familiar with some of the law’s specific provisions. For example, NBGH noted that 69 percent are at least somewhat familiar with the requirement that individuals must have or must purchase insurance; 63 percent know that large- and mid-sized employers must offer insurance to full-time employees. However, just 38 percent are aware of the creation of public health insurance exchanges.

“While employees have some knowledge about the ACA, they need to recognize that health reform brings with it additional costs for their employers and that, ultimately, they will be sharing in these costs,” said Helen Darling, NBGH president and CEO. “Neither employers nor the government can bear these added costs alone. At the same time, it’s encouraging that relatively few employees are concerned that their employer won’t provide health insurance benefits in the future. Additionally, employees are gaining confidence in their ability to shop for insurance and many are open to new and potentially cost effective ways to buy insurance through exchanges.”

Indeed, only 28 percent of respondents said they are not confident they can shop for health insurance on their own, compared with 37 percent who responded to a similar question last year. However, 47 percent are not confident in their ability to purchase the same or better quality health insurance on their own.

Exchanges. The survey found that even though 66 percent have not heard of a private exchange, when given an explanation of how it works, 52 percent said that they would be somewhat or very interested in purchasing health insurance through a private exchange if offered by their employer. And, 66 percent would shop through a public exchange if offered as a less expensive option. However, more employees would stick with their employer plan if the costs were the same and even if there were more choices offered in a public exchange.

“Employees have clearly gained confidence in the last year when it comes to purchasing health care on their own. This confidence probably arises from the opening of the public marketplaces. However, many employees are not confident in their ability to purchase the same or higher quality care. Employers will need to educate employees about the value of all their benefits, especially health benefits so that employees understand the total rewards they are receiving as part of their compensation,” said Darling.

The survey contains responses from 1,520 employees at organizations with 2,000 or more employees. For more information, visit

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