Same as it ever was: worker health benefit costs rise again

In the ever-shifting world of company-provided health insurance, here’s a constant: It keeps getting more expensive.

Workers may learn that their doctor will no longer be covered or they might have to pay a higher deductible before most coverage begins. Meanwhile, the employer paying most of the insurance bill faces the same big concern every year: The cost will probably rise higher than wages and inflation.

Employer-sponsored health insurance is the most common form of health coverage in the United States. The Kaiser Family Foundation estimates that it covers about 153 million people.

The cost of that coverage is expected to rise another 5% next year, according to the National Business Group on Health, which does health policy work and research for large companies.

The business group’s CEO, Brian Marcotte, spoke recently with The Associated Press about the latest challenges in health benefits. The conversation has been edited for clarity and length.

Q: What do big employers think about the possibility of a “Medicare for All” plan replacing what they offer, as some Democratic presidential candidates have proposed? Do they like the idea that the government may relieve them of this huge expense?

A: Employers want their employees to have access to the most efficient, high quality and affordable health care possible. Employers at this point view what they provide as being better quality.

The biggest challenge (they) see with what's being proposed now, nobody is talking about how you reform the delivery system to be more efficient. There's 30% waste within the system. You can't just expand access (to care) without addressing how care is being delivered.

Q: There's a wave of expensive specialty drugs being developed. Some cost a million dollars or more. Will employees have access to them?

A: I think employees will have access. Some companies will delay the first six months or so when a new therapy comes out before they cover it. Employers just want to make sure that they're working ... as advertised, and it gives their pharmacy benefit manger an opportunity to manage those therapies appropriately.

No one's really thinking of not covering these, but they're very concerned about the price.

Q: Employers are very interested in covering telemedicine to improve access to care, but employees often are slow to use the technology. Do workers or patients not trust it?

A: It may be more of a matter of not being used to accessing health care in that way.

Q: Companies are not raising deductibles as much as they have in the past, but they still want to cut costs. Where are they turning their attention?

A: They realize that health care is complex, that employees don't touch health care with a lot of frequency or most don't. They're bringing in more services to help employees navigate their benefits, navigate the delivery system, understand their treatment options.