Michelle M. Doty, Sara R. Collins, Cathy Schoen, Alyssa L. Holmgren
Historically, employers have been the primary source of health insurance coverage for working-age Americans and their dependents. Yet according to a recent survey of 453 employers, the job-based health system is under stress. The Commonwealth Fund Supplement to the 2003 National Organizations Study (NOS) finds that double-digit increases in health insurance premiums led employers to shift more of their health care costs to employees in 2002–03. But the survey also finds that most employers who offer health insurance see it as a core part of their compensation packages—a benefit that improves morale and productivity and makes it easier to recruit and retain employees. Employers voice strong support for many recent health reform proposals made by federal and state policy leaders to expand insurance coverage, including proposals that would require them to make financial commitments.