Benefits and Compensation

Survey: Most Employers Don’t Want Full Repeal and Replace of ACA

A new Mercer survey has found that only 35% of employers favor a full repeal of the Affordable Care Act (ACA), while 51% actually oppose it (and 14% have no opinion).  Instead, the survey found that employers prefer smaller changes to the law.These changes include:

  • Permitting higher contributions to health spending accounts—92%
  • Allowing contributions up to the level of the out-of-pocket maximum—87%
  • Allowing medications and treatments for chronic conditions to be covered in an HSA-eligible plan before the deductible is met—66%
  • Allowing free or subsidized services at an onsite clinic before the HSA deductible is met (which Mercer comments “might be the most cost-efficient, as well as the most convenient, source of primary care”)—61%

One likely contributing factor for employers’ tepid support for a full repeal and replace could be what they learned the details of 2017 legislative proposals for doing so, which Mercer notes “could result in more people without insurance or with significant insurance gaps… We asked employers whether they were concerned that these changes could result in providers’ shifting cost to employer group plans to help offset an increase in uncompensated or undercompensated care.”  Three in four (75%) of employers responded that they had a considerable amount of concern over this possibility.

The survey also covered what employers are doing to minimize their exposure of risk regarding the forthcoming excise task in 2020 and what their biggest concerns/cost drivers are related to health care.  For more details, visit

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