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What's Going on With Employer-Sponsored Health Insurance?

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Earlier this week the
Congressional Budget Office (CBO) released
its latest estimate
 of how much the health law would
increase insurance coverage. The CBO estimated that, as a result of
Obamacare, 12 million people will be insured this year who
otherwise would not have been.

The CBO’s estimate comes on the heels of a
survey by the RAND Corporation
, completed on March 28 of this
year, which found that health insurance coverage under Obamacare
rose by 9.3 million. 

At first glance, these might not seem to be wildly incompatible.
CBO’s figure is an estimate for the full year. RAND’s figure comes
from a survey that goes most of the way through March. In any case,
there’s going to be some amount of natural variation.

But RAND’s survey finds that the vast majority of the increase
came via a spike in employer-sponsored insurance; the findings
suggest that, perhaps as a result of the health law’s coverage
mandate, a large number of people obtained employer coverage who
did not previously have it. The CBO, in contrast, actually projects
a decrease in employer coverage of 2 million by next year, and a
further decrease of 7 million the year after that. It’s hard to
imagine a plausible, realistic scenario in which these two results
are compatible.

Was RAND’s unusual finding an artifact of fall open enrollment
periods for employer coverage, or even just a fluke result? The
study had a rather
large margin of error
, with the topline insurance figure
subject to a 3.5 million over or undercount. There are other
reasons to wonder about the survey results: Benefits manager Aon
Hewitt found
 that there was very little enrollment growth
amongst those eligible for employer health plans in the 2014
coverage year.

It’s hard to tell what’s actually happening here. RAND’s survey
results don’t match up to what almost anyone expected, but unlike
the CBO, which is crunching outside data to make a projection, RAND
is relying on their own measurements taken on the ground. If RAND
is right, though, then Obamacare’s effects will look quite
different from what anyone assumed, and the exchanges will be much
less of a factor than the law’s designers planned. I suspect it
will be a while before this is all sorted out.


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