David Bowie’s song “Changes” comes to mind as the Affordable Care Act (ACA) replacement morphed into the American Health Care Act and now the Better Care Reconciliation Act. Access to health care could be changing, and employers are reacting to possible workplace impacts. In Employer Pulse Check: The Future of ACA, the International Foundation of Employee Benefit Plans surveyed employers from across the country and found 71% would not like ACA repealed entirely.

Like the uncertainty that greeted employers when ACA was first introduced seven years ago, organizations are once again faced with the prospect of proposed changes that could impact their bottom line and make it difficult for future planning. With the possibility of new laws and regulations, employers will need to remain watchful in order to stay compliant.

If the ACA employer mandate were repealed, 96% of employers surveyed would continue to provide health benefits for workers. Of the organizations stating they would discontinue coverage, 64% of employers said it would be due to the high cost of providing coverage.

Top Employer-Supported Provisions

79% support the tax-favored status of employer-provided health coverage for employers.

76% support the tax-favored status of employer-provided health coverage for workers.

74% support the mental health benefit parity (i.e., the same level of benefits as for other medical conditions).

69% support expanded use/flexibility for health savings accounts.

67% support the ban on preexisting condition exclusions.

67% support increased wellness incentives as allowed under ACA.

Top Employer-Opposed Provisions

85% oppose the Cadillac tax (excise tax on high-cost plans).

65% oppose premiums based on medical experience (i.e., insurers can charge sicker individuals more).

52% oppose the increased age-based premium differential between younger and older individuals (e.g., increased from three to five times).

48% oppose the limit on health flexible spending accounts and salary reductions (i.e., $2,600 in 2017).

For more information and access to the full results, visit the Future of ACA.