Impact of Health Reform Bills on California Families and Employers Charts and Tables from Recent Briefs February 2010

UC Berkeley Labor Center, NORC at the University of Chicago, Towers Watson 2 Recent Briefs Californians’ Access to Coverage Under the Health Reform Proposals Ken Jacobs and Dave Graham-Squire December 2009 How Would Health Care Reforms Change the Spending of California Families Without an Employer Plan? Ken Jacobs, Laurel Tan, Roland McDevitt, Jon Gabel and Ryan Lore December 2009 National Health Reform Requirements and California Employers Jon Gabel, Ken Jacobs, Laurel Tan, Roland McDevitt, Jeremy Pickreign and Shova KC December 2009 All briefs available at

UC Berkeley Labor Center, NORC at the University of Chicago, Towers Watson 3 Californians’ Access to Coverage Under the Health Reform Proposals California private sector workforce by business size Source: Worker information from 2007 California Health Interview Survey, employer information from 2007 California Employer Health Benefit Survey Insured Workers Workers with job based coverage through employer Uninsured Workers Total Workers Share of Workers Number of CA Private employers (with more than 2 employees) Percent of CA Private employers Fewer than 50 5,310,000 2,140,000 2,030,000 7,340,00040%352,63591% , , ,000720,0004%14,3584% 100 or more 9,220,000 7,140, ,000 10,110,00056%20,5475% Total 15,120,000 9,690,000 3,040,000 18,160,000100%387,540100%

UC Berkeley Labor Center, NORC at the University of Chicago, Towers Watson 4 Uninsurance Rate by Industry Source: March Current Population Survey 2004 to 2009, ages 19-64

UC Berkeley Labor Center, NORC at the University of Chicago, Towers Watson 5 Californians’ Access to Coverage Under the Health Reform Proposals Employer eligibility for tax subsidies under HR 3962 for firms in California employing more than 2 employees Fraction of employers Fraction of workers 10 or fewer employees, average wage less $20, %2.0% 25 or fewer employees, average wage less $40,0006.8%2.1% More than 25 employees or wage more than $40, %95.9% Total100% Source: 2007 California Employer Health Benefit Survey, 2007 March Current Population Survey

UC Berkeley Labor Center, NORC at the University of Chicago, Towers Watson 6 Californians’ Access to Coverage Under the Health Reform Proposals Californians with employer-sponsored coverage (ages 0–64) HouseSenate Medicaid eligible 300,0001.5% 300,0001.5% Eligible for premium or cost-sharing subsidies in exchange 270,0001.4% 500,0002.6% Below 400% FPL with no subsidies in exchange 10,0000.1% 10,0000.1% Over 400% FPL 50,0000.3% 110,0000.6% Offered affordable ESI through employer or spouse's employer 18,970, % 18,670, % Total 19,600,000100% 19,600,000100% Source: California Health Interview Survey Rows may not sum to totals due to rounding.

UC Berkeley Labor Center, NORC at the University of Chicago, Towers Watson 7 National Health Reform Requirements and California Employers Percentage of employees covered by a plan without an out-of- pocket limit or with a lifetime maximum benefit Percentage of employees with insurance in plans with no OOP limit or an OOP limit more than $5,000 Percentage of employees with insurance in plans with no OOP limit or an OOP limit more than $5,950 Percentage of employees enrolled in a plan with a lifetime maximum benefit limit Size of firm 3-49 Employees31.5%*30.1%*44.3% Employees25.7%25.4%40.1% Employees16.6%*16.6%40.3% Region Los Angeles area28.6%28.6%*42.6% San Francisco area16.4%*16.0%*64.0% Rest of State22.0%20.2%52.7% Plan Type HMO28.8%* 21.3 %* PPO14.6%*13.5%*74.3%* POS24.9% 32.0% CDHP w/SO10.2%*7.0%*79,6%* CDHP w/o SO1.7%*0.5%*84.2%* Total23.0%22.5%41.2% Source: 2009 California Employer Health Benefits Survey *Estimated percentages are statistically different from all other plans at 0.05 level.

UC Berkeley Labor Center, NORC at the University of Chicago, Towers Watson 8 National Health Reform Requirements and California Employers Percentage of employees enrolled in a plan where preventive benefits are subject to a deductible and percentage of employees enrolled in a plan not covering prescription drugs Percentage of employees enrolled in a plan where preventive benefits are subject to a deductible Percentage of employees enrolled in a plan not covering prescription drugs Size of firm 3-49 Employees10.2%1.8% Employees11.2%0.8% Employees8.1%1.2% Region Los Angeles area7.1%1.5% San Francisco area11.5%0.3%* Rest of State11.6%2.4% Plan Type HMO1.0%*0.9% PPO20.7%*1.6% POS12.1%2.0% CDHP w/SO30.3%*0.9% CDHP w/o SO14.2%0.1%* Total9.6%1.2% Source: 2009 California Employer Health Benefits Survey *Estimated percentages are statistically different from all other plans at 0.05 level.

UC Berkeley Labor Center, NORC at the University of Chicago, Towers Watson 9 National Health Reform Requirements and California Employers Percentage of covered workers employed by a firm requiring more than 90 Days before eligible for health insurance coverage Percentage of covered workers employed by a firm with waiting periods of days Percentage of covered workers employed by a firm with waiting periods of more than 90 days Size of firm 3-49 Employees36.0%9.2% Employees40.1%7.2% Employees27.5%5.8% Region Los Angeles area44.1%7.5% San Francisco area33.3%12.9%* Rest of State26.7%3.3%* Industry type Mining/Construction/ Manufacturing /Transport 39.4%5.9% Wholesale/Retail/Finance45.6%14.4%* Service25.8%2.9%* Health Care43.4%10.0% Total35.7%6.0% Source: 2009 California Employer Health Benefits Survey *Estimated percentages are statistically different from all other plans at 0.05 level.

UC Berkeley Labor Center, NORC at the University of Chicago, Towers Watson 10 National Health Reform Requirements and California Employers Percentage of employees enrolled in an employer-based health plan where the employer does not contribute a minimum required percentage of the contribution Percentage of employees enrolled in a plan where the employer does not contribute 72.5% of amount of single coverage Percentage of employees enrolled in a plan where the employer does not contribute 65% of amount of family coverage Size of firm 3-49 Employees19.0%*50.5%* Employees11.0%37.0% Employees9.9%18.0%* Region Los Angeles area13.4%38.0%* San Francisco area7.4%*21.7% Rest of State19.5%*34.6%* Plan Type HMO11.1%31.1% PPO14.5%26.8% POS12.2%46.8%* CDHP w/SO13.9%32.7% CDHP w/o SO14.8%31.1% Total12.4%31.5% Source: 2009 California Employer Health Benefits Survey *Estimated percentages are statistically different from all other plans at 0.05 level.

UC Berkeley Labor Center, NORC at the University of Chicago, Towers Watson 11 National Health Reform Requirements and California Employers Percentage of employees enrolled in plans with an actuarial value less than 0.6 Percentage of employees enrolled in a plan with Actuarial value for Single coverage less than 0.6 Percentage of employees enrolled in a plan with Actuarial value for Family coverage less than 0.6 Size of firm 3-49 Employees1.0%2.0% Employees0.5%2.4% Employees0.4%1.9% Region Los Angeles area0.2%1.4% San Francisco area0.7%2.0% Rest of State0.9%3.3% Plan Type HMO0%0%* PPO0.2%1.7% POS0.6% CDHP w/SO5.1%17.9% CDHP w/o SO2.5%10.0% Total0.6%2.2% Source: 2009 California Employer Health Benefits Survey, MarketScan claims data. Watson Wyatt calculated actuarial values. *Estimated percentages are statistically different from all other plans at 0.05 level.

UC Berkeley Labor Center, NORC at the University of Chicago, Towers Watson 12 Distribution of Hours Worked by Industry in the United States Source: Current Population Survey Jan-Jun 2009, Ages 19-64, hours worked at main job

UC Berkeley Labor Center, NORC at the University of Chicago, Towers Watson 13 Distribution of Health Coverage by Hours Worked In California Source: March Current Population Survey 2004 to 2009, ages 19-64, usual weekly hrs if worked 40 or more weeks during the yearSource: March Current Population Survey 2004 to 2009, ages 19-64, usual weekly hrs if worked 40 or more weeks during the year Source: March Current Population Survey 2004 to 2009, ages if working under 30 hrs if working 30 to 36 hrs if working 37 or more hrsTotal ESI thru employer18%36%62%56% ESI thru others32%17%10%12% Public8%7%3%4% Individual Market / Other16%11%6%7% Uninsured26%28%19%20% Total100%

UC Berkeley Labor Center, NORC at the University of Chicago, Towers Watson 14 Californians’ Access to Coverage Under the Health Reform Proposals Californians purchasing coverage in the individual market (ages 0–64) Source: California Health Interview Survey Rows may not sum to totals due to rounding. HouseSenate Medicaid eligible 200, % 160,0008.3% Eligible for premium or cost-sharing subsidies in exchange 470, % 460, % Below 400% FPL with no subsidies in exchange 50,0002.6% 100,0005.2% Over 400% FPL 910, % 910, % Offered affordable ESI through employer or spouse's employer 280, % 290, % Total 1,920,000100% 1,920,000100%

UC Berkeley Labor Center, NORC at the University of Chicago, Towers Watson 15 How Would Health Care Reforms Change the Spending of California Families Without an Employer Plan? Cost to individuals with average health use for premiums and out-of-pocket medical expenses in existing California individual market compared to House and Senate bills after subsidies: Californians with single coverage, 150–400 percent FPL Source: Authors’ calculations from MarketScan 2006 Commercial Claims database from Thomson Reuters, California HealthCare Foundation Employer Health Benefits Survey 2006, California Market Tracking Survey 2006, and eHealthInsurance.com; CBO analysis of premiums under HR 3962