Business coalition worries health burden may shift

A leading business coalition has warned that employers could pick up the tab if millions of people lose their coverage under the Republican plan to repeal the Affordable Care Act.

David Lansky, president and chief executive of the Pacific Business Group on Health, a nonprofit organization whose members include Boeing, Chevron, Hewlett-Packard Enterprise, Intel, Walmart and the Walt Disney Co., said that the Senate proposal to repeal the Affordable Care Act could push the costs of providing health care to uninsured people onto employers and their workers.

“There are a couple of specific reasons continuing to support an effective Medicaid program and an individual market is important, and one of those is its importance to business,” Lansky said .

Approximately 177 million Americans receive insurance through employers. Until now those plans have been largely left out of the debate over the future of the Senate health bill, which would make longterm cuts to Medicaid, the government health program for the poor, and reshape the individual market where people buy their own coverage.

But if the bill is passed and more people are uninsured, or public sector programs facing federal funding cuts decrease their reimbursements, Lansky said, hospitals would simply shift those costs onto commercially insured patients — namely employers and employees.

Lansky added that if Medicaid is cut and the individual market doesn’t provide affordable, comprehensive coverage, new workers may delay care until they get a job — which could make workers less productive and also create an initial surge in health care costs that could increase premiums.

“Any additional cuts to public programs are likely to make additional increases to the employer and the employee — at a time that most of us are worried about what we’re spending on health care,” Lansky said.

Until now, big employers have praised elements of the health care bill that would benefit them and have been restrained in any criticism.

The U.S. Chamber of Commerce has been one of the few major industry groups to come out in support of the bill. The National Business Group on Health has praised the delay of the Cadillac tax that would have been leveled on generous health care plans and the greater flexibility in how health savings accounts could be used.

“The biggest impact on employers are the taxes and the added administrative requirements that have been imposed by the Affordable Care Act. We see the changes in those provisions, since they alleviate our concerns, as a good thing,” said Steve Wojcik, vice president of public policy at the National Business Group on Health.

But Lansky said employers are becoming aware that insurance markets aren’t as siloed as it was once thought.

Commercially insured patients generally pay higher rates for health care, in part to compensate for shortfalls created by public health care programs and the uninsured.