SPOTLIGHT ON EMPLOYERS by Jarrett Barrios and Valerie Bassett

In health care this week, attention is on employers, and it begins with the release today of a new survey on employers and health care reform. The news is promising. Employers largely support health care reform and the fair share requirement, and we have observed little sign of “crowd-out,” or employers dropping coverage.

The Blue Cross Blue Shield of Massachusetts Foundation, joining with the Robert Wood Johnson Foundation, funded researchers at the National Opinion Research Center (NORC) to survey Massachusetts employers on coverage trends generally as well as their perceptions of health care reform and how it will affect them. There’s a lot of information in the survey – data which will be available for analysis through NORC as a public use file. Some of the findings are analyzed in a Health Affairs web-exclusive article published today authored by NORC Senior Researcher Jon Gabel. See the Foundation website for the report as well as the press release and chartpack.

So how does it look out there for employers in the early days of health care reform? Simply put: better than we thought.

Many assumed that small employers in particular would resist health care reform, resent the fair share requirement, and start to drop health insurance altogether, leaving the state to foot the bill. They did not.

The data show that in the early stages of health care reform – the survey was conducted between February and June of 2007 — employers believed that they bore some responsibility for health insurance. A strong majority even believed that all employers—including those with fewer than 11 employees-- should either provide health insurance or pay a fair share assessment. This makes some sense when you see that 63% of Massachusetts firms with fewer than 11 employees already offer coverage. To those businesses, it must seem only fair that others do their part.

In Massachusetts, 57% of workers are covered by their employers. What employers do is a critical element in expanding coverage for all residents. It is good to know they see themselves as part of the solution.

This Thursday, employers will have to submit state forms that will determine if they meet the state’s tests for fair coverage participation or if they will have to pay the fair share assessment. In next year’s survey, it will be important to watch if and how employer attitudes and health insurance choices change. In the months to come, we’ll also learn through state tax filing who is enrolled in health insurance and who is not. It will be critical to understand what the factors are and what government – and employers — can do to close this gap.

Jarrett Barrios, President
Valerie Bassett, Director of Policy and Research
Blue Cross Blue Shield of Massachusetts Foundation