Large Employers Continue Offering Health Coverage; Small Employers’ Offerings on the Decline, Report Finds

The number of large employers sponsoring health plans for their employees has held steady since the 2014 enactment of the ACA, though the percentage of smaller employers sponsoring health plans has steadily declined since 2009, according to a report from the Employee Benefit Research Institute. More than 95% of companies with 100 or more employees offered health coverage prior to the ACA and continue to do so; the 2015 rates for smaller employers ranged from 23% for companies with fewer than 10 employees to 74% for companies with 25 to 99 employees. Companies with fewer than 10 employees saw the greatest percentage decline between 2008 and 2015 (a 36% decline). The report’s authors cite several reasons for small employers sponsoring coverage less frequently, including: rising healthcare costs (both actual and the fear of future rising costs), the availability of non-group Marketplace coverage, and the 2007-2009 recession and the weak recovery that followed. The authors also note that smaller firms may face higher and more volatile premium increases and that health insurance plays a smaller role in worker recruitment and retention at smaller firms.

Oregon: Study Finds Correlation Between ACA and Improved Financial Health of Hospitals

An Oregon Health Authority (OHA) study found a 38% increase in operating margins and a 40% decrease in uncompensated care across Oregon's 60 acute care hospitals between 2014 and 2015. The study, which also found a 38% reduction in bad debt, attributes this improved financial performance to a 9% drop in the uninsurance rate, spurred by the State's adoption of Medicaid expansion and its establishment of a State-based Marketplace. The study's authors analyzed annual financial reports that acute care hospitals are mandated to submit to OHA.

Texas: New “Healthy Texas Women” Combines Programs to Expand Coverage and Services

Health and Human Services Executive Commissioner Charles Smith announced the State’s new “Healthy Texas Women” program, which combines the “Texas Women’s Health Program” and “Expanded Primary Care for Women” program due to a 2014 recommendation by the Sunset Advisory Commission aimed at streamlining several State healthcare initiatives. The combined program is operated by the State Health and Human Services Commission, which also now operates the separate family planning program, previously administered by the Department of State Health Services. The streamlined Healthy Texas Women program offers expanded services, including those for chronic conditions such as hypertension, diabetes, and high cholesterol in addition to previously offered immunizations, family planning, cancer screenings, and contraceptive services. Women between the ages of 18 and 44 with income below 200% of FPL are eligible, and women as young as 15 are newly eligible with parental consent. Women previously enrolled in either program will be auto-enrolled into the newly combined program. The prior Texas Women’s Health Program was established in 2013 with State funds only, replacing the State and federally-funded Medicaid family planning waiver program. The Expanded Primary Care for Women program was introduced in 2015 and offered primary, preventive and screening services to women at or below 200% of FPL who were unable to access the same care through other programs.