Views on Employment-Based Health Benefits: Findings From The 2014 Health and Voluntary Workplace Benefits Survey

Enactment of the Patient Protection and Affordable Care Act of 2010 (ACA) has raised the question: Will employers continue to offer health coverage in the future, and if so, to which workers? As noted in previous work, health insurance exchanges combined with insurance-market reforms (such as guaranteed issue, modified community rate, and subsidies) give workers expanded options for health coverage beyond employment-based coverage.

The Urban Institute and others have concluded that there will be relatively little net change in the number of people with employment-based coverage in the short term as a result of the ACA. However, there is less certainty (and less research) on the longer-term effects. In 2012, the Congressional Budget Office (CBO), for example, examined a number of scenarios and in one found that there could be 20 million fewer people with employment-based coverage by 2019. More recently, it has been predicted that fewer than 20 percent of workers will have coverage through their job by 2025.

Some of the findings highlighted in the article include:

• Employers continue to report that they do not plan to drop health coverage, which is widely viewed as a key employee benefit highly valued by workers; but if a few large employers drop coverage, others could follow in a “me too” effect.

• Most workers are satisfied with the health benefits they have now and express little interest in changing the current mix of benefits and wages offered by their employers.

• Overall, workers are of mixed opinions when it comes to their preferred methods for obtaining health insurance. Forty percent prefer to continue getting coverage the way they do today. Forty-one percent prefer to choose their insurance plan, having their employer pay the same amount it currently spends toward that insurance, and then paying the remaining amounts themselves. And 19 percent prefer their employer to give them the money and allow the workers to decide whether to purchase coverage at all and how much to spend.

• Choice of health plans is important to workers, and they would like more choices, but most workers express confidence that their employers or unions have selected the best available health plan. Moreover, they are not as confident in their ability to choose the best available plan if their employers or unions did, in fact, stop offering coverage.

• Individuals are not highly comfortable that they could use an objective rating system to choose health insurance nor are they extremely confident that a rating system could help them choose the best health insurance.

The full report was published in the February 2015 EBRI Notes. For more information, visit

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