1 in 5 Large Employers Gather Data from Workers’ Mobile Apps, FitBits or Other Wearable Devices

San Francisco, Calif. – Annual family premiums for employer-sponsored health insurance rose 5 percent to average $19,616 this year, extending a seven-year run of moderate increases, finds the 2018 benchmark Kaiser Family Foundation Employer Health Benefits Survey released today. On average, workers this year are contributing $5,547 toward the cost of family coverage, with employers paying the rest.

Annual premiums for single coverage increased 3 percent to $6,896 this year, with workers contributing an average of $1,186.

This year’s premium increases are comparable to the rise in workers’ wages (2.6%) and inflation (2.5%) during the same period. Over time, the increases continue to outpace wages and inflation. Since 2008, average family premiums have increased 55 percent, twice as fast as workers’ earnings (26%) and three times as fast as inflation (17%).

This year’s survey also finds the burden of deductibles on workers continuing to climb over time in two ways: a growing share of covered workers face a general annual deductible, and the average deductible is rising for those who face one.

“Health costs don’t rise in a vacuum. As long as out-of-pocket costs for deductibles, drugs, surprise bills and more continue to outpace wage growth, people will be frustrated by their medical bills and see health costs as huge pocketbook and political issues,” KFF President and CEO Drew Altman said.


Currently 85 percent of covered workers have a deductible in their plan, up from 81 percent last year and 59 percent a decade ago. The average single deductible now stands at $1,573 for those workers who have one, similar to last year’s $1,505 average but up sharply from $735 in 2008. These two trends result in a 212 percent total increase in the burden of deductibles across all covered workers.

Looked at another way, a quarter (26%) of all covered workers are now in plans with a deductible of at least $2,000, up from 22 percent last year and 15 percent five years ago.  Among covered workers at small firms (fewer than 200 workers), 42 percent face a deductible of at least $2,000.

“Deductibles of $2,000 or more are increasingly common in employer plans, which means the bills can pile up quickly for workers who require significant medical care,” said study lead author Gary Claxton, a KFF vice president and director of the Health Care Marketplace Project.

About 152 million Americans rely on employer-sponsored coverage, and the 20th annual survey of nearly 2,200 small and large employers provides a detailed picture of the trends affecting it. In addition to the full report and summary of findings released today, the journal Health Affairs is publishing an article online with select findings that will appear in its November issue, and KFF is releasing an updated interactive graphic that charts the survey’s premium trends by firm size, industry, and other factors.

The survey finds 57 percent of employers offer health benefits, similar to the share last year (53%) and five years ago (57%). Employers that do not offer health benefits to any workers tend to be small, and nearly half (47%) cite cost as the main reason they do not offer health benefits.

Some employers that offer health benefits provide financial incentives to workers who don’t enroll –either for enrolling in a spouse’s plan (13%) or otherwise opting out of their employer plan (16%).

The survey also probes employers’ expectations about how the 2017 tax law, which eliminated the Affordable Care Act’s tax penalty for people who do not have health insurance, would affect enrollment in employer coverage in future years. Overall 10 percent of all offering firms – and 24 percent of large ones – expect fewer workers and dependents to enroll because of the elimination of the tax penalty.

Among large firms that offer health benefits, one in five (21%) report they collect some information from workers’ mobile apps or wearable devices such as a FitBit or Apple Watch as part of their wellness or health promotion programs. That’s up from 14 percent last year.

Most large offering employers (70%) provide workers with opportunities to complete health risk assessments, which are questionnaires about enrollees’ medical history, health status, and lifestyle, or biometric screenings, which are health examinations conducted by a medical professional, or both. Thirty-eight percent of large offering firms provide incentives for workers to participate in these programs. The maximum financial incentives for these and other wellness programs often total $500 or more.

Other survey findings include:

  • High-deductible health plans with savings option. The survey finds 29 percent of firms that offer health benefits offer a high-deductible health plan with a savings option – a plan that either can work with a Health Savings Account or is linked to an employer-created Health Reimbursement Arrangement. Most (61%) of those firms offer only this type of plan to at least some of their workers. Overall, 29 percent of covered workers are enrolled in such plans.

  • Telemedicine. About three quarters (74%) of large offering firms (at least 200 workers) cover services provided through telemedicine, such as video chat and remote monitoring, which allow a patient to get care from a provider at a remote location. That’s up from 63 percent last year and 27% in 2015. A separate analysis also released today suggests very few workers are using telemedicine services in place of traditional in-person physicians visits, as less than 1 percent of all enrollees in large employer health plans used any telemedicine services in 2016.

  • Retail health clinics. Similarly, three quarters (76%) of large offering firms cover services received in retail clinics, such as those located in pharmacies, supermarkets and other retail stores. A small share also provide financial incentives for workers to use these clinics.


The annual survey was conducted between January and July of 2018 and included 4,070 randomly selected, non-federal public and private firms with three or more employees (including 2,160 that responded to the full survey and 1,910 others that responded to a single question about offering coverage). For more information on the survey methodology, please visit the Survey Design and Methods Section.

Original article by Kaiser Family Foundation

AuthorMeg McComb

Whether it was bracing for a possible repeal of Obamacare or pondering an ambitious single-payer program that would overhaul how California provided medical care to its residents, the issue of healthcare kept politicians and policy wonks busy in 2017.

That’s not likely to let up in 2018.

Decisions by Congress and the Trump administration could shift priorities in the state budget. The crusade for single-payer healthcare is sending lawmakers — and candidates — scrambling. And long-simmering issues such as rising prescription drug costs continue to draw attention in Sacramento.

Here’s a primer on the healthcare agenda in California politics.

1. All eyes on Washington, D.C.

The GOP-led effort to repeal and replace the Affordable Care Act fizzled, but in the tax overhaul, congressional Republicans managed to roll back a long-targeted provision of the healthcare law: the individual mandate that requires people to buy insurance or pay a penalty.

The repeal of the individual mandate will likely result in higher insurance premiums across the country, according to the Congressional Budget Office, because healthier people would drop out of the market, leaving insurers with a sicker — and costlier — risk pool.

The mandate repeal could upend insurance exchanges in states with few insurers or high costs. In California, the impact would be softened because there are more insurers participating and new consumers joining the market, said Peter V. Lee, executive director of Covered California, the state’s insurance exchange.

“The individual mandate is an important element of the Affordable Care Act, but it is not the glue that holds it all together,” Lee said. “The secret sauce to affordability is the financial assistance provided through subsidies,” which have not changed.

Uncertainty from the federal government has kept Covered California on its toes. In August, officials announced that premiums for insurance plans for the next year would rise by an average of 12.5%. The exchange also stepped up its marketing and outreach spending in hopes of addressing confusion stemming from Washington.

Some policymakers, including Lee, have mulled the possibility of a state-level individual mandate, but that would require a major legislative lift.

Also on the horizon: a potential tug-of-war over government healthcare programs such as Medicare and Medicaid. House Speaker Paul D. Ryan (R-Wis.) has said he wants to tackle “healthcare entitlements” in the coming year.

Any changes to Medicaid funding could have drastic impact in California, where a third of residents get healthcare through Medi-Cal, as the program is known in the state.

“We are very much girding for a mother of all Medicaid battles,” said Anthony Wright, executive director of Health Access California, a consumer advocacy group.

Gov. Jerry Brown’s administration will be closely monitoring the goings-on in Washington, but don’t expect any contingency plans to be laid out in public when the governor unveils his budget plan.

“Until and unless there is a change in federal law...the rule of thumb is we budget under current law,” said H.D. Palmer, spokesman for Brown’s Department of Finance.

2. The brawl over single-payer continues

California Democrats put up a united front in opposing repeal of the Affordable Care Act. But another major healthcare proposal — a statewide single-payer system — fractured the party in 2017 and is poised to deepen those divisions.

Senate Bill 562, which would establish a system in which the state would pay for nearly all healthcare costs for its residents, electrified liberals. But Assembly Speaker Anthony Rendon (D-Paramount) shelved the bill, calling it “woefully incomplete” because of a lack of funding and other unanswered questions about implementation, sparking a backlash from his party’s leftward flank.

Seeking to redirect the debate, the Assembly has held a number of hearings in recent months to explore how to achieve “universal healthcare,” be it through a single-payer model or other ways to expand coverage. The hearings compared systems in other states and countries and looked into other ways to control costs.

Wright said it’s likely that new policy proposals will result from the hearings and the debate sparked by SB 562. Assembly Democrats already signaled they’ll be seeking to expand Medi-Cal access to cover all uninsured adults, including those without legal immigration status.

“There is a growing desire to figure out what are the major steps we can take forward to get to universal or near-universal coverage,” Wright said.

The California Nurses Assn., which sponsored the single-payer bill, wants to see that legislation move forward.

“It’s full speed ahead as far as we’re concerned. Nothing’s changed,” said Don Nielsen, policy director for the union. “The momentum is there. We need to do single-payer guaranteed healthcare for all.”

Expect the heated single-payer debate to ripple through the state’s marquee political races for governor and U.S. Senate, too.

3. Prescription drugs remain in the spotlight

Labor groups, consumer advocates and health insurers notched some major wins against the pharmaceutical industry in 2017. Two high-profile laws passed: increasing disclosure on how prescription drugs are priced and cutting back on the use of discount coupons, which some studies suggest help contribute to high premiums.

The battle is set to carry on into 2018. Drug manufacturers have sued in federal courtto block the disclosure law, SB 17, arguing it is unconstitutional and “intentionally exports California's policy choices regarding prescription drug pricing on the entire nation.”

The Legislature will consider at least three additional bills to address drug prices. Assemblyman Jim Wood (D-Healdsburg) is working with the Brown administration on AB 315, which would establish regulations of pharmacy benefit managers, which act as middlemen between drug makers and purchasers.

Also pending is SB 790 by Sen. Mike McGuire (D-Healdsburg), which would limit gifts that pharmaceutical companies can give to doctors, and AB 587 by Assemblyman David Chiu (D-San Francisco), which would require state agencies to meet regularly to find ways to curb drug costs.

“We want to work with legislators on real solutions that will help patients,” said Priscilla VanderVeer, deputy vice president of public affairs for Pharmaceutical Research and Manufacturers of America.

original post by Melanie Mason at LAtimes.com

AuthorMeg McComb