Fewer Americans and fewer Georgians are getting health insurance through their employers, and those who do are paying a lot more, according to a study released Tuesday from the Robert Wood Johnson Foundation.
A separate report released simultaneously from the Urban Institute said that provisions in the Affordable Care Act should help smaller employers offer health insurance but that advocates were split on whether it really would work.
Looking at two-year averages, the foundation reported that since 1999-2000, the percentage of people getting employer-sponsored insurance in 2008-09 declined by 9.5 percentage points in Georgia, from 69.3 to 59.8, compared with a drop of 8 points nationally, from 69.4 to 61.4 percent. Premiums over that same period in Georgia skyrocketed by 79 percent for individuals and 75 percent for families, compared to 82 percent and 75 percent nationally, according to the report.
Those numbers were not surprising to Holly Lang, the director of the Hospital Accountability Project for consumer group Georgia Watch, particularly in light of the recession.
"We had it a little bit worse than the national average," she said. "Inevitably, folks are going to look to scale back costs and to do whatever they can to save money. So unfortunately, one of those things to go we've seen has been health insurance offered by the employer."
Virginia Galloway, the state director for Americans for Prosperity Georgia, called the decline troubling.
"Employers continue to drop coverage as health care costs sky-rocket," she said.
That could force people into buying their own insurance, and they find that they probably can't afford it or won't be offered it because of pre-existing conditions, which won't be addressed for adults by the Affordable Care Act until 2014, Lang said.
A federally created health insurance for those with pre-existing conditions recently dropped its premiums by 15.5 percent but about a month ago only 515 people in Georgia had signed up, Lang said. She estimated that perhaps 100,000 to 200,000 people in Georgia would be eligible and are likely the working poor who wouldn't qualify for other programs.
"What it does is just leave uninsured patients who are going to be reliant on hospital indigent/charity care programs or the use of local clinics or, unfortunately for many, just not seeking care at all," Lang said. "And that's where we become very concerned."
That delay in care often results in more advanced disease, "which is expensive to the patient, it is expensive to the hospital, it is expensive to everyone," she said.
The analysis by the Urban Institute points to tax breaks through the Affordable Care Act, some of which took effect in 2010, that should make it easier for those smaller employers, who traditionally struggle to offer health insurance. Those with fewer than 50 employees could see their costs decrease by 12 percent, the report estimated. When fully implemented, the reforms will slightly increase health insurance costs for those firms with 50-99 employees -- by 1.2 percent -- but the report expects insurance rates for those employers to remain relatively stable.
Galloway, however, said the reforms are "not the solution":
"The Congressional Budget Office itself estimates at least 10 million to 12 million workers will lose their employer-sponsored insurance starting in 2014. Many will be shifted into Medicaid."
In testimony before Congress on March 30, the Congressional Budget Office actually estimated that 1 million fewer people would get employer-sponsored insurance, beginning in 2018, with 16 million more people covered by an expanded Medicaid and Children's Health Insurance programs and 23 million purchasing insurance through the Insurance Exchanges. The uninsured were decreased by 33 million.
"Individuals and employers want choices, not federal mandates, to control rising costs," Galloway said.
Lang said it is a shame the issue has become so politicized because many have not taken the time to see what is actually beneficial to them in the new law.
"We strongly feel that if folks were more aware of how they could benefit from this and were able to push political leanings aside and just take advantage of what is a pretty good deal for folks, they would benefit more," she said.