Despite enormous changes in the health care and health insurance markets over the last decades, employment-based insurance is still the single largest source of coverage for Americans. A recent Employee Benefits Research Institute survey gathered data on employee perspectives on health insurance and trends in those views. (EBRI Article) Almost all workers describe some level of satisfaction with their current health plan–12% (government workers most likely) are extremely satisfied; 38% are very satisfied and 41% are somewhat satisfied. Employees seem to have at least some understanding of the interplay between wages and health benefits, with 14% saying they would be willing to sacrifice pay for better health benefits and 20% expressing the opposite opinion, they would give up some health benefits to get higher wages. Since 2012, the percent willing to trade benefits for more pay has doubled. About half of employees say they would give up a wage increase to keep health benefits. If the cost of health insurance paid for by employers became taxable as wages, 50% of employees say they would still keep the same level of coverage. 29% would want to switch to less costly plan offered by their company, 16% would prefer to shop for coverage directly from insurers and 5% would drop coverage.
Many employees seem open to new approaches to providing health benefits. While 44% say they prefer the current approach in which employers generally select plan options that employees can choose among and the employer pays the bulk of the premium, 40% would prefer to choose their insurance plan and have the employer just contribute what it currently pays to whichever plan the employee picks and 16% would like the employer to just give them the money that goes toward health insurance and let them decide if they want to buy health coverage at all and how much to spend. Partly this may reflect another finding: choice across many health plans is extremely important to 41% of workers, very important to 39% and somewhat important to 17%. 70% are somewhat to extremely interested in having more health plan options than they currently do. While they want more plans, employees tend to be uncomfortable with using an objective rating system to help choose health insurance. The most important factors in selecting a plan continue to be the premiums, the cost-sharing amounts, the annual out-of-pocket limit and providers covered, although this has become less important, probably as employees see that lower premiums are often attached to narrower networks. Overall the survey results reflect employee attribution of high value to health benefits, but a willingness to take more responsibility for selecting a plan.