A new survey underscores the concern that Americans feel about possible changes in the health care landscape, but also offers a glimmer of hope: whatever happens, employers remain committed to providing health benefits.

The Transamerica Center for Health Studies (TCHS) survey is an annual study of employer decision-makers; it included results from 1,350 respondents in its latest report. The survey finds many of the same issues that the business community has struggled with in recent years: challenges with keeping health care costs in line, employees who worry about losing health coverage, efforts to create a healthier work force, and concerns about policy changes and regulations on the state or federal level.

“With ongoing uncertainty about health policy in Washington and state capitols, employers are consistent in their commitment to employee health coverage,” said Hector De La Torre, executive director of TCHS. “Employers also acknowledge the cost burden, but are finding ways to maintain health insurance for their workers as a key employee benefit.”

Health care offerings increased

The 2018 TCHS study found employers are offering benefits at the highest level since 2013, the first year the study was conducted. The survey says that 85 percent of employers report offering health benefits to their full-time employees. In addition, 36 percent of employers report they added health insurance or added other health care benefits (32 percent). On the other hand, 11 percent say they reduced or eliminated company contributions to cover costs for health care benefits other than health insurance, and nine percent say they did the same for health insurance costs.

Keeping an eye on Washington

The politics of health care remains a concern for employers. The survey found that 61 percent of employers say their company is extremely or very aware of the potential changes to health care policy coming out of Washington D.C.

When asked how they would like their company to respond if the federal employer mandate is removed (which has been proposed as part of repealing or reforming the Affordable Care Act), 25 percent said they would not make any changes, but 24 percent said they would re-evaluate their options. Sixteen percent of respondents said they would expect their company to increase coverage. Fiver percent said they would reduce coverage as much as possible.

Employers are aware of how concerned their workers are about possible changes to health care policy—72 percent of respondents said that employees have expressed at least some fears with respect to changes in health care policy; most commonly, the possibility of losing their health care due to pre-existing conditions (27 percent).

Managing rising costs

The survey found that most employers are concerned about costs; 80 percent of respondents said their company is taking steps to manage their health care costs. Seventy-three percent of companies are concerned about the affordability of health insurance for their employees, a similar number, 72 percent, report being concerned about employees being able to afford their out of pocket health care expenses.

The strategies for holding down costs are varied, the most commonly-reported strategies are comparison shopping for the best health insurance options and finding ways to reduce premiums (both at 36 percent).

Wellness efforts seem to be popular, according to the survey, but there is still less-than-universal adoption of such programs. Respondents say that wellness programs have positively impacted job satisfaction (77 percent), workers' commitment (73 percent), turnover (61 percent), and absenteeism (59 percent). In addition, close to 80 percent say wellness programs have had a positive impact on workers' health, productivity, and performance. And 71 percent say these programs have had a positive impact on company health care costs.

However, the survey found that more than one-third of employers (36 percent) say they do not offer these types of programs to their employees.

What else should employers expect in the new year?

Instant Insights /

Despite uncertainty, business are committed to health insurance coverage

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