Employers want workers to cover rising health insurance costs: Is this progress?

According to a new report by the Kaiser Family Foundation, insurance premiums are rising at 'historically low rates.' Part of the reason for this: Healthcare costs are increasingly shifting to the employee, in the form of higher deductibles.

Tony Leys/ The Des Moines Register/AP/File
Robert Bruns of Colfax, Iowa, poses for a photo at the CareMore clinic in Des Moines, Iowa. Leaders of the new east-side Des Moines clinic say they can help patients stay healthy while saving money for the insurance company that owns the place.

Although the Affordable Care Act, also known as "Obamacare," which insures around 11 million Americans, is the most-publicized health insurance option, more than 150 million people still get coverage through their employers. And the way these companies are distributing costs has been subtly shifting.

The amount employees are paying for healthcare is rising, according to a new report by the Kaiser Family Foundation. That's because deductibles – the amount that families generally have to pay before insurance kicks in – are going up. Unlike under ObamaCare, there are no caps on these payments. 

Over the past few years, increasing numbers of workers have moved to high-deductible plans. These plans keep premiums – the total which must be paid on the plan – down: They rose just 3 percent in the past year. But employees' healthcare costs continue to rise, because they’re picking up more of the tab. Is this progress? It depends who you ask.

"There's been a gradual sea change in what insurance is for most Americans, from more comprehensive coverage to skimpier coverage," Drew Altman, president of the Kaiser Family Foundation, told NPR.

But for employers, the move to higher-deductible plans is a way to protect their businesses against the escalating costs of healthcare. As the Kaiser report shows, premiums have risen 20 percent in the past five years – and that's a far slower rise than historically. 

Dave Anderson, chief executive officer of HealthNow, Inc., told NPR that raising deductibles from $200 to $1,000 can cut about 20 percent off the total cost of healthcare. That's often good news for employees, too, since it brings down the payment they make every month.

One significant impact of the plans, according to the report, is that they change the way that employees use health services. If out-of-pocket costs go up, employees may become more open to healthcare alternatives, including employer-sponsored wellness programs and clinics that aim to offer similar outcomes at lower cost.

Some employers incentivize their workers toward preventative measures, such as exercising more and trying nutrition plans, by offering to pay half an employee's deductible if he or she goes through an annual health risk assessment.

There is still a concern that the deductibles may go too far for lower income workers, limiting their access to essential services. That could ultimately impact workers' overall health and productivity at work. But according to Amanda Frost, a senior researcher at the Health Care Cost Institute, it's still too soon to tell.

“Given how new all of this is – the new prevalence of these plans, the newly identified reduction in service use trend – I think it’s going to be interesting to watch and see what the health implications of this are,” Ms. Frost said to The Washington Post.

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