AHRQ Views

Leading up to 2014, many questioned how employer-sponsored insurance would change in response to the Affordable Care Act. Recently released data from the Agency for Healthcare Research and Quality (AHRQ) show that many changes in employer-sponsored insurance from 2013 to 2014 are in line with changes from prior years, with a small decline in offers of coverage, consistent with prior years; a small increase in premiums, lower than historical increases; rates of self-insurance largely unchanged; and increases in deductibles consistent with prior trends.

AHRQ recently released a chartbook, national tables and brief, and State tables on the cost and availability of employer-sponsored insurance during the first year that major provisions of the Affordable Care Act took effect. AHRQ's data come from the Insurance Component of our Medical Expenditure Panel Survey (MEPS), a group of large-scale surveys of individuals and families, medical providers, and employers across the United States.

The MEPS Insurance Component provides detailed information on insurance coverage and premiums. While other sources (e.g., the Kaiser Family Foundation / Health Research & Educational Trust) also provided estimates for 2014, AHRQ's large sample allows for State-level estimates and more precise estimates by firm sizes affected by Affordable Care Act provisions.

Differences across regions are another important story from the MEPS IC data. Nationwide, nearly half (49.8 percent) of employees of small firms (fewer than 50 workers) worked at establishments that offered insurance. Across States, the share of employees in small firms offered insurance ranged from about a third of small firm employees in South Carolina (33.2 percent) and New Mexico (34.3 percent) to more than two-thirds in Massachusetts (68.1 percent) and Hawaii (93.1 percent).

Among Census Divisions, New England and the Mid-Atlantic had the largest share of States with above average offer rates among small firms and the largest share of States with single premium costs above the national average. The South Atlantic and West South Central Census Divisions had the largest share of States with lower than average offer rates, while the East South Central and Mountain Census Divisions had the largest share of States with lower than average single premium levels.

The many changes in health care financing raise the stakes on monitoring and understanding changes in insurance coverage and premiums. That's why an established data resource such as the MEPS Insurance Component is so valuable. Providing this consistent, reliable source of data on how the law is performing will give us the insight we need to inform future policy decisions and help employers, too. For more information, please see the recently released chartbook, national tables and brief, and State tables.

Richard Kronick, Ph.D., is Director of the Agency for Healthcare Research and Quality.