Almost two-thirds of large U.S. employers in 2011 plan to ask employees to pay for a larger portion of their health coverage to reduce an expected increase in costs, partly attributed to the federal health reform law, according to survey released on Tuesday by the National Business Group on Health, Bloomberg/San Francisco Chronicle reports (Young, Bloomberg/San Francisco Chronicle, 8/19).

The survey, which drew responses from 72 large employers with 3.7 million workers, was conducted in May and June.

Survey Findings

According to the survey, respondents said they expect their overall health benefit costs to increase by an average of 8.9% in 2011, compared with 7% in 2010 (Lillis, “Healthwatch,” The Hill, 8/18).

Provisions included in the recently enacted health reform law are expected to contribute an estimated one percentage point toward that total, according to Helen Darling, president of NBGH (Bloomberg/San Francisco Chronicle, 8/19).

The survey — titled “Large Employers’ 2011 Health Plan Design Changes” — found that among respondents:

• 63% intend to make workers pay a higher percentage of their premium costs next year, up from 57% in 2010;
• 46% plan to raise the maximum level of out-of-pocket costs that workers would pay;
• 44% plan to raise deductible rates for in-network providers (Reichard, CQ HealthBeat, 8/18);
• 61% plan to offer a consumer-directed health plan in 2011 (Murphy, AP/MSNBC, 8/18);
• 53% are willing to revise the design of their employees’ health care plans, such as removing lifetime dollar limits on overall benefits and specific benefits, and eliminating provisions that exclude coverage for children with pre-existing medical conditions (CQ HealthBeat, 8/18);
• 37% plan to change annual or lifetime limits on specific benefits, including dental, mental health and infertility benefits; and
• 25% plan to raise copayments or co-insurance costs for prescription drug benefits at retail pharmacies, while 21% are planning to implement similar increases for mail-order pharmacy benefits (“Healthwatch,” The Hill, 8/18).

Implications of Findings

The survey likely will foster debate over the health reform law’s effect on health care costs (“Healthwatch,” The Hill, 8/18).

Some experts have said attributing the cost increases to the reform law could be disingenuous.

Health researcher Igor Volsky of the Center for American Progress suggested that employers could be using the overhaul as the reason for cost increases that they already were planning to implement (Bloomberg/San Francisco Chronicle, 8/19).