This morning, the Blue Cross Blue Shield of Massachusetts Foundation shared results from two recent studies on the role of Massachusetts employers in health reform. Both surveys, one conducted by the Urban Institute and the other by the National Opinion Research Center, show that Massachusetts health reform is on track and making progress. A third survey published today by Robert Blendon looks at public attitudes towards chapter 58.
- No crowd out: More small firms are offering coverage. Employers are not tightening eligibility, are not reducing coverage, and are not shifting costs to workers. Half of all firms who paid the fair share contribution plan to offer coverage next year.
- Employer support for reform up: 68% support the fair share assessment. Half of all firms think a 4% payroll tax on non-offering employers would be more fair than the $295 assessment.
- Public support up: Overall public support is at 69%, compared to 61% in 2006. Support for the individual mandate is steady, at 58%. Support for the fair share assessment at 75%, up from 70%.
Dr. John Holahan presented the findings from the study conducted by Sharon Long at the Urban Institute, focusing on employer responses to health reform from the perspective of employees. Comparing employee responses from fall 2007 and fall 2006, the study finds that employers continue to offer coverage at a high rate. Employers also are not tightening eligibility, increasing employee premium contributions, or reducing the scope of benefits. In fact, cost sharing for workers at companies with 51 or fewer employees decreased from 32% in 2006 to 24% in 2007; workers also reported a significant drop in unmet need for health care because of cost. Overall, employees continue to report high levels of satisfaction with their ESI coverage.
The Massachusetts employer survey conducted by Jon Gabel and the National Opinion Research Center (NORC) compares survey results from Spring 2007 and Spring 2008. Overall, the employer community’s support for health reform continues; 52% of all firms surveyed agreed that health reform has been good for Massachusetts. An overwhelming majority of firms (77%) agreed that all employers bear some responsibility for providing health benefits to their workers, with 68% of firms supporting the fair share regulations, and applying these requirements to firms with 10 or fewer workers.
Quelling the concerns about crowd-out, the NORC study finds that Massachusetts employers are not dropping coverage during health reform implementation. In fact, 79% of Massachusetts companies with three or more workers offered health coverage to their employees in spring 2008, up from 73% in spring 2007. Gabel credits this increase to the individual mandate, which gave employers an incentive to offer coverage to their employees. This is in contrast with the nationwide trend where the percentage of firms nationwide offering coverage has remained unchanged during this period. Massachusetts firms were also less likely than firms nationwide to indicate plans to drop coverage or restrict eligibility in the future.
The survey on public attitudes towards reform is here.