2009-06-19
On May 22, 2009, Hewitt's Ken Sperling provided a written statement to the Senate Finance Committee, regarding "Expanding Health Care Coverage: Proposals to Provide Affordable Coverage to All Americans."

Sperling stated that employers are the single largest source of coverage for working Americans and their families, and the system is highly valued by both employers and employees. As the nation pursues a path leading to universal coverage, the most important consideration is how to accomplish this goal in a way that preserves, strengthens, and stabilizes existing employer-based coverage.

Our statement summarizes some of these insights based on Hewitt's extensive experience advising large employers on their health care plans, and draws heavily upon the experience of Hewitt's consultants and actuaries who have extensive knowledge of — and direct experience with — the employer-sponsored health care system, the health insurance marketplace, and the emerging market trends and strategies aimed at broadening access, controlling cost, and improving the health and productivity of the U.S. workforce.

The statement addresses the following provisions of the policy options document where our employer experience is relevant or the proposed options are applicable to the large-employer market:

• Health Insurance Exchange — According to a recent Hewitt survey of more than 500 human resources executives, 85 percent were in favor of achieving universal coverage for all Americans. There was no clear consensus, however, on the preferred method to meet this goal.
• Benefit Options — First, we would suggest that all benefits be subject to a reasonable and objective standard of medical necessity to prevent overutilization of services. Second, while most large employers provide nominal or no cost sharing for preventive services, these services are typically provided according to objective, evidence-based guidelines (e.g., those defined by the U.S. Preventive Services Task Force). We would encourage the Committee to use these guidelines. Third, there are several questions that arise when examining the Committee's proposed options and associated actuarial values. We would suggest further clarification of some of the terms and statements.
• Public Health Insurance Option — Large employers would prefer to support Option B, relying on private options in a reformed and well-regulated private market to provide competitive and affordable choices.
• Medicare Buy-In for Pre-65 Retirees — In general, employers support the transition of disabled persons from employment-based plans to public plans, including Social Security disability insurance and Medicare, as a matter of public policy.
• Pay or Play — The existence of an employer pay-or-play requirement would have far-reaching effects on the private care system across all employers.

For additional information about this written statement, please view the PDF file linked to at right.

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