Texas business group to lobby for lower employer health care costs

This column by Nicole Cobler and Asher Price on TAB's fight to lower employer health care costs was published by Axios

Three months before the legislative session begins, the state's leading business lobbying group has its sights set on lowering health care costs for employers.

The big picture: Texas Association of Business president and CEO Glenn Hamer said the group will push lawmakers to pass policies that will reduce employers' health insurance costs as opposed to mandates "that will put health insurance coverage out of range for a number of Texas small businesses."

Yes, but: Over the last two decades, employers have been shifting health care costs to workers, leaving them with more out-of-pocket costs and less cost certainty, Anne Dunkelberg, a senior policy analyst at the progressive think tank Every Texan, tells Axios.

  • Plus: Workers are increasingly on the hook for employer contributions. "A worker is paying that money," Dunkelberg says. "The amount the employer is contributing to the benefit is a dollar-to-dollar-tradeoff with your cash wages."

Zoom out: The growth of high-deductible plans led to people with employer-sponsored coverage paying for a larger share, on average, of their health care costs between 2013 and 2018, according to a July analysis by the Employee Benefit Research Institute.

What they're saying: Hamer said inflation has already hurt small businesses and additional policies that could raise costs could make it impossible for such companies to offer health insurance at all, making them less competitive.

  • For smaller businesses that are competing for talent … the deciding factor for an employee could be whether or not an employer offers health insurance," Hamer said. "Any legislative effort that makes that more difficult for a small employer is going to make that company less competitive."

Of note: Small businesses with 50 or fewer employees are not required to offer group health insurance coverage.

  • But small businesses that decide to offer coverage must make it available to all employees who work 30 hours or more each week.

By the numbers: A new survey from the Texas Association of Business, first provided to Axios this week, found that 87% of its members believe in-state businesses should oppose legislation that could increase the cost of employer-paid health care coverage.

  • The survey, conducted by Baselice & Associates from June 3 to July 5, also found that health care is the most attractive benefit for attracting and retaining employees.

  • More than 75% say the Legislature should give employers more flexibility to contain costs.

Flashback: The Texas House Committee on Insurance held an interim hearing in May to study the impact of the U.S. Supreme Court's 2020 decision in Rutledge v. Pharmaceutical Care Management Association.

  • The high court ruled in December 2020 that the Employee Retirement Income Security Act did not preempt an Arkansas law regulating large employers who self-fund their health benefits.

  • The decision provided a window for states to increase regulation on employers who self-fund their own health plans.

  • But the business association found that 75% of its members oppose the state interfering with employer sponsored health plans.

The bottom line: Hamer said the business community is unified against any legislative activity that would "increase the costs of the most important benefit that employers can offer."

What's next: The Texas Legislature convenes Jan. 10.