For now, at least, large and midsize employers may be more interested in increasing use of health account programs than getting health insurance for active employees from exchanges.
The Patient Protection and Affordable Care Act of 2010 (PPACA) calls for state and federal agencies to set up a network of health insurance exchanges, or Web-based insurance supermarkets, for individuals and small employers by 2014.
States could eventually choose to open their exchanges up to larger employers.
Even in 2014, larger employers could drop their own health coverage, pay a penalty to the federal government, and send employees to buy coverage on the PPACA exchanges.
Traditional benefits brokers, Web-based brokers and technology companies have been setting up similar, private exchanges aimed at larger employers, and at individuals and small employers that want an alternative to the PPACA exchanges. In California and some other states, exchanges and exchange-like programs have been available for decades.
The analysts found that only 13 percent of the participating employers said they thought they would be getting health benefits for active employees through the PPACA exchanges or private exchanges by 2016, and only 11 percent thought they would be getting health benefits for retirees from the exchanges.
About 57 percent already offer high-deductible health insurance together with health savings accounts (HSAs) or health reimbursement arrangements (HRAs), and the employers' suggested that percentage could increase 14 percentage points, to 71 percent, by 2018, the analysts said.
About 38 percent of the employers said they expect to offer a health plan that meets the minimum PPACA requirements, then give active employees an option to "buy up."