Population health concept

When the Affordable Care Act (ACA) was passed in 2010, one of the main concerns — which was often used to argue against passage of the health care reform bill — was that Americans would stop enrolling in employer-based plans and instead jump to the government-controlled ACA marketplace.

More than ten years later, that prediction has not come true. In fact, companies and employees alike seem to see health benefits as an important feature of employment, with companies often competing to offer the best health plans at the most affordable price. A new report, “What Employers Say About the Future of Employer-Sponsored Health Insurance,” found that employers see health benefits as a valuable recruitment and retention tool and have worked hard to keep such benefits as an expected part of the relationship between employer and employee. As a result, more than 70% of working Americans get their health insurance through their employer.

The new report, released by the Employee Benefit Research Institute (EBRI) and supported by the Commonwealth Fund, a private foundation that supports independent research on health care, looked at the impact of the ACA on employment based benefits, and also examined other government solutions, such as individual coverage health reimbursement accounts (ICHRAs), which were created in 2019 to allow employees to purchase health plans directly from the ACA from accounts funded by employers. The researcher found that by and large, ICHRAs had not caught on with workers in the U.S.


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