22% of Employers Waver on Adhering to ACA Preventive Care Rules

The coronavirus pandemic brought underscored the role of preventive care services in employee health, but in light of recent litigation, 28 percent of employers were either unsure of whether they would continue covering all preventive care services as per the Affordable Care Act or were planning to be more selective in their coverage, a survey from National Alliance of Healthcare Purchaser Coalitions (National Alliance) found.

“The pandemic has reinforced the critical role of immunizations in workforce health strategy but it also raised newfound concerns, confusion and misinformation,” Michael Thompson, president and chief executive officer of National Alliance, said in the press release. “With the end of the public health emergency, employers expect to double down on education and employee engagement to encourage vaccinations across the board.”

The organization released the online poll in April 2023 and it was available until May 2023. Twenty-nine National Alliance employers answered the poll, ranging from less than 1,000 employees to over 10,000. In total, the respondents represented around 1.5 million employees.

Overall, employers indicated that they would continue to offer preventive care services.

This is particularly important given the larger context: days before National Alliance launched its survey, a district court judge ruled that employers do not have to cover preventive care services without cost-sharing in accordance with the Affordable Care Act. This litigation is ongoing, with the Department of Justice having filed for an appeal, and the ultimate impact is unknown.

Amidst these uncertainties, National Alliance found that almost three-quarters of employers would continue offering full coverage for preventive care services (72 percent). Almost a quarter were not sure how the ruling would affect their coverage going forward (22 percent). And six percent of employers said that they intended to be more selective in which preventive care services they cover.

Additionally, 14 percent of employer respondents will fully cover over-the-counter COVID-19 tests, while a third will not. Seven out of ten respondents said they would cover coronavirus treatment similar to how they cover related noncoronavirus treatment (71 percent) and nearly a quarter will cover treatment in full (24 percent).

More than eight out of ten employers indicated that the coronavirus pandemic had increased their focus on not just coronavirus vaccines but all vaccines and immunizations. Almost every employer stated that primary care engagement was crucial for preventive care (96 percent).

Nearly eight out of ten employers have continued to track employees’ COVID-19 vaccination rates (79 percent), and almost two-thirds are tracking influenza vaccinations (63 percent).

Many employees were not fully vaccinated due to confusion or misinformation—this was the case for 71 percent of employees without full COVID-19 vaccination and 29 percent of employees who were not fully vaccinated with other vaccines. Lack of trust in vaccines was another significant factor for both coronavirus vaccines and other immunizations (71 percent and 33 percent, respectively).

Employers indicated that they considered themselves a more trusted source for vaccination information when compared to health plans. Over eight in ten respondents stated that employers are a trusted source on vaccine information, while 62 percent could say the same about health plans.

In separate research, employees have expressed trust that their employers will offer benefits that contribute to employees’ well-being.

As litigation around the Affordable Care Act’s preventive care services requirements continues, employers’ priorities related to these services will continue to be important.