The National Compensation Survey and the Affordable Care Act: preserving quality health care data
With the passage of the Patient Protection and Affordable Care Act, the National Compensation Survey has worked to evaluate the potential effects on the cost, coverage, and provisions for the employer-sponsored health care data it currently publishes; and explore possibilities for future collection and publication efforts. The approach has included researching the details of the law and evolving regulations, listening to the suggestions and concerns of stakeholders, and testing collection of new data elements.
The National Compensation Survey (NCS1) is a program within the Bureau of Labor Statistics that provides comprehensive measures of employer costs for worker’s compensation based on an establishment survey. The survey also tracks the incidence and provisions2 of employer-provided benefits for workers. Following the passage of the Affordable Care Act (ACA3) in 2010, the NCS has researched and monitored the law to evaluate the potential effects in continuing to provide comprehensive health care cost and coverage measures, and to identify opportunities to provide additional health care related data. This article provides an overview of efforts to research the effects of the ACA on NCS cost, coverage, and provisions data, including obtaining expert feedback and testing selected elements for potential inclusion in future data collection.
The NCS produces both the quarterly Employment Cost Index (ECI) and the Employer Costs for Employee Compensation (ECEC). The ECI, a Principal Federal Economic Indicator, captures compensation cost changes in the United States; and the ECEC provides employer cost levels for employee wages and salaries and 18 individual benefits. In addition to the ECI and ECEC, the NCS collects and publishes extensive data on employer-provided benefits, with an emphasis on health care and retirement. For the September 2014 reference period, the NCS collected data from 10,200 establishments in the United States representing private industry, as well as state and local governments.
The employer-provided benefit with the largest average cost is health insurance. (See table 1.) In September 2014, health benefits accounted for 8.5 percent of total compensation paid to civilian workers and 27.3 percent of employer benefit costs overall.
|Compensation Component||Civilian Workers||Private Industry||State and Local Government|
|Wages and salaries||68.7||69.8||64.0|
|Retirement and savings||5.2||4.1||10.0|
(2)Supplemental pay benefits include overtime and premium pay, shift differentials, and nonproduction bonuses.
(3)Insurance benefits include health, life, and short-term and long-term disability.
(4)Legally required benefits include Social Security, Medicare, federal and state unemployment insurance, and workers' compensation.
Source: U.S. Bureau of Labor Statistics, Employer Costs for Employee Compensation.
Since 1982, the NCS has documented the percent change in employer costs for health insurance in the ECI. The data show that employer health benefit costs have often outpaced average employer benefit cost increases from March 1982 to September 2014. In the 12-month period ending September 2014, employer costs for health benefits for private-industry workers increased 2.6 percent. (See figure 1.)
In addition to employer costs data, the NCS also publishes detailed health provisions data on medical care, dental care, vision care, and outpatient prescription-drug coverage. For example, of the private-industry workers participating in medical plans in 2013, 80 percent had coverage for outpatient mental health care. For private-industry workers with outpatient prescription-drug coverage, 80 percent required a copayment for generic drugs. The median copayment for generic drug prescriptions was $10 per prescription.
In March 2014, the average monthly employer premium paid for all civilian workers contributing to medical coverage was $377.84 for single coverage and $913.77 for family coverage. (See table 2.) Employers paid, on average, 81 percent of health insurance premiums for workers selecting single coverage and 69 percent of premiums for workers selecting family coverage.
ACKNOWLEDGMENTS: The authors would like to thank the following Bureau of Labor Statistics staff for their assistance with the article: Paul W. Carney, Emily M. Fasano, Thomas G. Moehrle, and Patricia D. Tam.
1 The use of NCS throughout the article references program, staff, processes, and data.
2 The term provisions throughout the article refers to NCS data elements related to a particular type of plan, service, condition, premium, or potential cost for health care.
3 For simplicity, we refer to the Patient Protection and Affordable Care Act and the companion Health Care Education Reconciliation Act as the Affordable Care Act.