Transamerica Institute

The First Annual Transamerica Center for Health Studies Survey:Benchmark on Health Care Coverage Perceptions and Readiness is a comprehensive examination of both Employers and Consumers as they face a shifting health care coverage landscape. The Survey, conducted by Harris Interactive in July 2013, asked 2,505 randomly selected Americans and 758 randomly selected Employers questions about their health care preferences and  preparedness for and expectations relating to the Affordable Care Act (ACA).  The  executive summary and complete findings can be accessed through the link above.

Highlights from the Survey

The 2014 mandate for individual health coverage is looming, especially for the 43 percent of the General  Population in the Survey who do not have insurance through an Employer. Many of them are still undecided about where they will obtain coverage.

43 percent of the General Population does not currently have coverage through an Employer and 21 percent do not have health insurance at all.  

With the individual health coverage mandate taking effect in 2014  and open enrollment in the State Exchanges starting October 1, 2013, among those who do not have health insurance through an Employer:

  • 39 percent are not sure about where they will get health coverage
  • 36 percent plan to keep their current coverage
  • 17 percent plan to purchase health coverage through a State Exchange
  • 8 percent do not plan to purchase insurance and pay the penalty. 

Despite concerns among many Employers that health coverage costs may rise due to the ACA, very few expect to drop their health coverage and the majority do not anticipate labor force reductions.

Many Employers (41 percent) expect the ACA to negatively impact their company’s health coverage costs in the next 2-3 years and 27 percent expect a positive impact. The majority of Employers (59 percent) expect their company’s benefits plan design to change. However, only 7 percent expect to remove health insurance in the next 1-2 years.

Few Employers (19 percent) anticipate a reduction in employees as a result of the ACA. The majority of Employers (61 percent) do not anticipate any changes and, interestingly, 20 percent anticipate increasing employees.

An information gap exists where few Employers provide what Workers say they need to decide about health coverage options.

Workers say they need the following information to make decisions about their health insurance options in the next 1-2 years:

  • A description of the benefits available is needed by 51 percent of Workers.
  • A comparison of how health insurance costs may change is needed by 50 percent of Workers.
  • A comparison of coverage among plans available is needed by 47 percent of Workers.

Only 12 percent of Employers provide all three of these pieces of information.

  • A description of the benefits available is provided by 47 percent of Employers.
  • A comparison of how health insurance costs may change is provided by 24 percent of Employers.
  • A comparison of coverage among plans available is provided by 30 percent of Employers.
  • Online tools and benefits advisors are seen as the most helpful channels for seeking health coverage-related information by Workers (59 percent and 47 percent, respectively) yet are less likely to be offered by Employers (40 percent and 32 percent, respectively).

Employers and Workers face directly conflicting interests regarding health insurance coverage: Employers prioritize lower costs over higher quality, while Workers prioritize higher quality over lower cost.

The majority of Workers (62 percent) prefer to pay more for a higher quality health coverage option compared to only 38 percent who would prefer to reduce insurance costs even if it means lower quality.

In direct opposition, the majority of Employers (57 percent) prefer to reduce coverage costs even if it means a lower quality option. Only 43 percent of Employers prefer to pay more for a higher quality option.

Workers in small businesses are more likely to feel uninformed about their current options for health insurance. Furthermore, they are less likely than those in medium or large companies to feel prepared to make decisions regarding their health insurance options that may be impacted by the ACA.

  • One-third (32 percent) of small business workers  feel uninformed about their health insurance options, compared to 21 percent in medium or 18 percent in large companies.
  • Employees in small businesses (58 percent) are less likely than employees in medium (68 percent) or large (70 percent) companies to feel prepared to make health insurance-related decisions as a result of the ACA.