The Pulse Check on Employer Preparedness for the ACA is a follow-up survey to Transamerica Center for Health Studies’ September 2013 benchmark study of the U.S. general adult population and employers regarding their attitudes toward health care. The “pulse check” survey assesses employers’ level of awareness and preparation given the ACA health care mandates for many businesses. TCHS commissioned Harris Poll to conduct the online survey with 300 employer decision-makers between March 26 and April 7, 2014. TCHS is not affiliated with Harris Poll.

In September 2013,  TCHS released findings from its inaugural national survey of Consumers and Employers regarding their attitudes toward health care. The overall goals for the study were to illuminate emerging trends, promote awareness, and help educate the public. TCHS then conducted a brief follow-up survey among the general adult population regarding their attitudes towards health care in November 2013 – which was five weeks into the ACA open enrollment period. 

The  2014 TCHS Pulse Check Survey is available with an Executive Summary.

Highlights from the Survey

Employers are significantly more informed about their companies’ options for offering health insurance than they were in 2013. Thirty-two percent more employers reported being very informed in 2014.

  • In the 2013 benchmark study, only 37 percent of employers reported being very informed about their options. In 2014, 69 percent are very informed.

More employers think their number of employees will increase due to the ACA.

  • Twenty-eight percent of businesses expect the number of their employees to increase as opposed to decrease (15 percent) as a result of the ACA.

Over a quarter (29 percent) of employers are researching actions that may avoid the need to fully comply with ACA mandates.

  • Almost a quarter (23 percent) of U.S. businesses are researching reductions in employees or full-time employees in preparation for the ACA implementation.
  • A third of businesses with 100+ employees are researching reductions.
  • Fifteen percent are calculating the cost of the tax penalty vs. the cost of complying with the ACA.

A significant number of small businesses are not well informed about the Small Business Health Options Program (“SHOP”).

  • Although eight in ten companies are aware of the SHOP, only six in 10 businesses with fewer than 50 employees are aware.
  • Just seven percent of small businesses intend to offer employees coverage through SHOP.

Most employers expect changes resulting from the ACA, but details remain unclear.

  • Most (64 percent) employers plan to take action as a result of the ACA.
  • But no particular change is cited by more than 20 percent of businesses.
  • Nineteen percent plan to change plan options
  • Seventeen percent plan to tighten requirements for employees to be eligible for health care benefits
  • Seventeen percent plan to change insurers

Medium size (50-99 employees) employers are aware of ACA mandate deadline extension.

  • Ninety-one percent of employers with 50-99 employees are aware that the deadline of January 2015 for companies of their size to offer employees health care insurance was extended to January 2016.
  • Virtually all (98 percent) employers of this size were aware of the mandate in the first place.

Despite concerns that the ACA would cause companies to eliminate dependent coverage, it appears there may be very little net effect on dependent coverage.

  • Ten percent of companies reported that they plan to eliminate coverage of dependents from their health plans, but nine percent said they plan to add dependent coverage as a result of ACA.

As part of its Pulse Check: Benchmark on Health Care Coverage Perceptions and Readiness, TCHS has created fact sheets highlighting targeted survey results. 

Fact Sheet: Employers

Fact Sheet: Small Business

Fact Sheet: Women-owned Business

Fact Sheet: ​​Minority Owned Business