Will Divestment from Employment-Based Health Insurance Save Employers Money? The Case of State and Local Governments

Jeremy D. Goldhaber-Fiebert, David M. Studdert, Monica S. Farid, Jay Bhattacharya

NBER Working Paper No. 20222
Issued in June 2014, Revised in July 2015
NBER Program(s):Program on the Economics of Aging, Health Care Program, Health Economics Program, Public Economics Program

Reforms introduced by the Affordable Care and Patient Protection Act (ACA) build new sources of coverage around employment-based health insurance. But what if firms find it cheaper to have their employees obtain insurance from these sources, even after accounting for penalties (for non-provision of insurance) and employee bonuses (to ensure the shift is cost neutral for them)? State and local governments (SLGs) have strong incentives to consider the economics of such “divestment”; many have large unfunded benefits liabilities. We investigated whether SLGs would save under two scenarios: (1) shifting all employees and under-65-retirees to alternative sources of coverage; (2) shifting only employees whose household incomes indicate they would be eligible for federally subsidized coverage and all under-65-retirees. Full divestment would cost SLGs more than they currently pay, due primarily to penalty costs. Selective divestment could save SLGs nearly $129 billion over 10 years at the expense of the federal government.

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Document Object Identifier (DOI): 10.3386/w20222

Published: Jeremy D. Goldhaber-Fiebert & David M. Studdert & Monica S. Farid & Jay Bhattacharya, 2015. "Will Divestment from Employment-Based Health Insurance Save Employers Money? The Case of State and Local Governments," Journal of Empirical Legal Studies, vol 12(3), pages 343-394.

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