Most working Americans obtain health coverage through their employers. Neither presidential candidate is proposing to change that, although each of their plans, if enacted, would affect employers substantially. But over a third of U.S. employers (almost exclusively small employers, with fewer than 500 workers) do not sponsor an employee health plan and one of the central questions of the reform debate is how they might be induced to do so. According to a major new employer survey on health care reform released by Mercer, the majority of these employers believe that employee medical coverage is far beyond their means.
When asked their primary reason for not offering health coverage, 43 percent of all employers without employee plans answered “I can’t afford it.” Other reasons included employees being covered under other plans (20 percent), high workforce turnover (9 percent), and the perception that employees would rather have more pay than health coverage (9 percent). When asked how much they would be willing to contribute per employee per month if they were to offer a health plan, 59 percent of these employers said that amount ranges from zero to no more than $50. Only 10 percent said they would pay at least $200.
“This finding highlights how tough it’s going to be to ask very small employers to voluntarily take on the expense of providing health coverage,” said Linda Havlin, a Mercer worldwide partner. “It also helps explain why even relatively low-cost catastrophic plans like HSAs have not made great inroads with small employers that find it financially challenging to offer coverage.”
