The government health program fights in Washington could hit small employers hard, because government programs provide health benefits for 19% of their workers.
Medicaid covers 5% of all U.S. workers and 11% of workers at employers with fewer than 50 employees, according to a Commonwealth Fund survey results posted Thursday.
Individual and family plans purchased through the Affordable Care Act public exchange system cover 3% of all workers and 8% of workers at small employers.
About 4% of all workers, and 12% of workers at small employers, are uninsured.
Avni Gupta and Sara Collins, the Commonwealth Fund analysts who reported the results, were summarizing data from a survey that was sponsored by the fund and conducted in May.
The Commonwealth Fund is an independent research center that’s more popular with Democrats than with Republicans, but policymakers affiliated with both parties use its survey data.
What it means: Gupta and Collins predicted that keeping the recently adopted changes in place and implementing other changes now in the pipeline will decrease the number of workers with Medicaid or ACA exchange plan coverage and increase the number with no health coverage.
“Ultimately, these efforts will undermine the health of the U.S. workforce,” Gupta and Collins wrote.
Policy changes: Supporters of moves to decrease U.S. federal government involvement in health coverage say letting the government dominate the health care market increases administrative complexity, increases the overall cost of care and fails to do enough to improve access to necessary, high-quality care to justify the added spending.
The administration of President Donald Trump has imposed new ACA exchange plan enrollment rules in an effort to keep people from lying about characteristics such as income, location and American Indian heritage to maximize the amount of federal premium subsidies they get.
Congress has also been letting emergency health insurance access measures adopted in response to the COVID-19 pandemic expire.
Temporary changes that made getting and keeping Medicaid coverage easier began to end in 2023.
Provisions that increased ACA premium subsidy levels and expanded access to subsidies are set to expire Dec. 31.
In some cases, workers who have been getting ACA exchange plan coverage for free, or for payments of less than $100 per month out of their own pockets, will have to pay more than $500 per month to continue to use exchange plan coverage.
Affordable Care Act employer shared responsibility rules: The ACA “shared responsibility” system, or “pay or play system,” now requires employers with 50 or more full-time, year-round employees to provide major medical coverage for many employees or else face the possibility of having to pay penalties.
The Commonwealth Survey shows that only 2% of the workers at “applicable large employers” are uninsured. About 3% have Medicaid coverage, and 2% have exchange plan coverage.