A few weeks ago, the consulting firm McKinsey released a controversial study claiming that employers would drop coverage in large quantities when the full Affordable Care Act is implemented. The Obama Administration immediately downplayed the study and then sought to get further information about it released. In the meantime, a separate study from Avalare Health came to the opposite conclusion, surmising that the employer market “will be fairly stable after 2014 when key ACA coverage provisions go into effect” and that “most employers will remain committed to providing coverage.” And now, McKinsey has released the full methodology for their findings, and they have basically walked away from the conclusions.
The report, which Republicans have been using to argue that American’s won’t be able to keep the coverage they have even if they like it, found that up to 30 percent of employers would stop offering insurance. But in the methodology summary just released, McKinsey stresses that the report “was not intended as a predictive economic analysis of the impact of the Affordable Care Act. Rather, it captured the attitudes of employers and provided an understanding of the factors that could influence decision making related to employee health benefits.”
This is pretty much a public relations disaster for McKinsey. They’re clearly trying to claim that their study wasn’t making a prediction about the employer market, when the initial results actually show a strong lean in that direction, particularly the line that “the shift away from employer-provided health insurance will be vastly greater than expected and will make sense for many companies and lower-income workers alike.”
But it’s worth mentioning that “fairly stable” does not mean that no employer will drop coverage in future years under the ACA. In fact, dropping coverage is the current trend, and while there’s a weak penalty that would have to be paid by employers under the ACA, it’s not likely to create a major deterrent if the numbers show a net benefit to a company. The Congressional Budget Office, more respected in these matters than McKinsey at this point, estimated that “the number of people obtaining coverage through their employer would be about 3 million lower in 2019 under the legislation.” The Centers for Medicare and Medicaid Services found a lower number, on the order of 1.4 million. These aren’t huge numbers, but they aren’t nothing either.
More importantly, the erosion of the employer market could be arrested in one of several ways. The first is through a real employer mandate with a legitimate “pay-or-play” mechanism. Another is by letting all employers into the exchanges. And finally, we could dismantle the entire inefficient employer-based system, with its fracturing of the risk pool, and instead move to a single-payer or all-payer system that would save money and provide more quality care.
Just because McKinsey messed up its survey doesn’t mean that the subject of the survey is worth preserving. The employer-based system was developed in the 1940s as an accident and just doesn’t work as well as other proven systems for health coverage. I don’t believe it’s worth defending, even from bad studies.




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How would opening up the exchanges help preserve the employer based system?
OT:Keith Olbermann is on next somewhere on your TEEVEE. I can’t wait. This is going to make his Special Comment moments look like a cakewalk
On topic: A year of health care kabuki and we’re all going to wind up with none at all.
I don’t think that’s what I’m saying, but it depends on the mechanics. If workers were allowed to use the employer health deduction to purchase on the exchanges, it would not necessarily strengthen them, but it would strengthen worker’s ability to have portable health insurance. If businesses could go on the exchanges, it would increase the risk pool for exchange plans and possibly lower costs, which would be attractive to employers. Depends on how it’s structured.
I don’t really care about preserving the employer-based system, I care about making sure everyone gets health insurance.
IMO if major employers, en mass, dropped employer paid/supported health care tomorrow, we’d have Medicare for all by Wednesday. If Google, IBM, GM, etc., quit playing the insurance game, it would be over.
Some of the really big employers are self-insured, and aren’t touched AT ALL by the Affordable Care Act. In fact, the self-insurance setup turns out to be a profit center for them.
Okay, I didn’t realize that. The big companies I’ve worked for would self insure, some areas, like dental and eyes, and even vehicle insurance if they had a lot of people in company cars, but not health insurance.
“…was not intended as a predictive economic analysis of the impact of the Affordable Care Act.”
That sounds so much like Sen. Kyl’s spokesperson, “Not intended to be a factual statement.”
Lies and lying liars.
The link to the actual response from McKinsey is the fifth link on this page, after the links to the partisan sites ThinkProgress & TPM, s well as the quote that shows Republicans quoting the study. This seems designed to provoke the reptile brains of your more partisan readers.
I read the full comments posted by McKinsey and have followed this story closely since the beginning. They never claimed the study was an economic forecast and always said it gauged the opinions of employers who had influence in the benefits decisions of their companies. They have walked back nothing. If anything, they have appeased the repeated requests of a White House that would very much like for another narrative to fly.
It’s really sad that this is how low the Democratic Party that I once loved has fallen, relying on propagandists to dog whistle their way to an irrational and angry electorate. Looking increasingly like Republicans circa 2003. I’m beginning to think the only answer is a big fat no on voting for candidates of either legacy party. It seems like whichever one gets in, their side turns more authoritarian.
Good point.
Sorry, but I don’t think conducting survey administered by IPSOS should be equated with going down with flames – FDL itself uses PPI for surveys, yet here FDL is. I’ve searched the news from the time and I haven’t seen McKinsey advertising it as other than a survey.
http://www.mckinsey.com/en/US_employer_healthcare_survey.aspx
I think you mean that it doesn’t mean that the subject ISN’T worth preserving (because it IS).
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Connecting the dots…
I credit this to McKinsey’s desire to do more business with the insurance industry. They have take a very pro-insurance posture, as when they advised Allstate to put boxing gloves on to cover the “good hands.”
What’s up with all the spam lately? There was a time at the Lake when this shit wouldn’t see the light of day.
If they wanted to do more business with the insurance industry they’d praise Obamacare with its individual mandate.