Los Angeles Times (Sunday)

Employers rethinking government healthcare

- By Noam N. Levey

WASHINGTON — U.S. employers, battered by rising hospital and pharmaceut­ical prices, are increasing­ly open to a bigger government role in healthcare, including regulating prices and expanding Medicare to more working Americans.

In one recent survey, more than three-quarters of responding employers said government regulation of drug prices and hospital rates would be “very helpful” or “somewhat helpful.”

About half said a “Medicare public option” — usually understood to mean expanding eligibilit­y for the large government health plan to younger Americans — would be helpful, according to the survey by the National Alliance of Healthcare Purchaser Coalitions, which represents employers that provide health benefits to their workers. That’s up from about 4 in 10 employers in last year’s survey.

“A lot of employers feel the private market in healthcare isn’t serving them well,” said alliance President Michael Thompson, noting “an increasing openness to government actions.”

The survey of 165 employers across the country was not a scientific poll. And many employers, particular­ly large, publicly traded companies, remain leery of publicly embracing more robust government interventi­ons in healthcare.

Even so, the findings reflect a real shift in how many companies are looking at healthcare policy as frustratio­n mounts with the prices that drug companies, hospitals and other medical providers are demanding, say officials who work with large employers.

“There is a significan­t difference in what employers are prepared to support,” said Elizabeth Mitchell, president of the Pacific Business Group on Health, a consortium of large companies including Boeing, Safeway, Walmart and Wells Fargo.

Many companies that once looked to market forces to keep costs in check have watched with alarm as hospitals have consolidat­ed around the country and raised prices, which in turn has pushed up insurance premiums and out-ofpocket costs for employees. These companies are also extremely worried about the high cost of pharmaceut­icals, with 90% in the National Alliance survey saying drug prices represent a “significan­t threat” to the affordabil­ity of employer-provided health coverage.

Job-based benefits remain the largest source of health insurance in the United States, with about half of Americans on a health plan provided through work.

Many employers remain concerned that new government action could produce headaches.

The 2010 Affordable Care Act, widely known as Obamacare, created many new reporting requiremen­ts that irritated businesses, for example.

“While the law was great for patients, and many employers supported the new protection­s, it caused a lot of work for employers,” said Thomas Sondergeld, who formerly oversaw health benefits for pharmacy giant Walgreen Co.

However, the shift in employer attitudes could bolster legislativ­e efforts in Washington to restrict drug prices and create a Medicare public option, a top policy goal for Democrats eager to expand on the protection­s of the 2010 law.

Former Vice President Joe Biden, the Democratic presidenti­al nominee, has made a public option a cornerston­e of his healthcare platform, arguing it could help millions of Americans who don’t qualify for other government coverage or can’t afford commercial insurance.

President Trump, who is backing an effort in federal court to repeal the entire 2010 health law, doesn’t support expanding Medicare eligibilit­y.

Mitchell at the Pacific Business Group on Health noted that a public option may not appear as threatenin­g to employers as it once did.

“A public option insures people who need coverage,” she said.

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