Editorial: Closer look reveals health poll's flaws

A new health care survey has set off a firestorm by suggesting that 9 percent of U.S. businesses will end medical coverage after the Affordable Care Act takes full effect in 2014.

But a closer look at the Towers Watson survey, whose flaws were compounded by even more flawed media coverage of it, reveals that it is not the "Obamacare" indictment it's been made out to be.

Among the red flags that went unnoted: The benefits consulting firm only put out a news release about its findings.

The release was not accompanied by the usual report detailing the survey's methodology and findings. The e-mail survey also had a 12 percent response rate, an oft-omitted but crucial detail.

Another caveat: The 9 percent of employers said to be "ending" health insurance -- a key finding highlighted by media -- are not planning to simply cut off employees.

What they are considering, according to additional information provided to an editorial writer, is replacing current coverage with a "financial subsidy" so that employees can buy their own plan once the comparison-shopping health insurance websites known as "exchanges" become operational.

That concept should sound familiar to anyone who voted for Republican John McCain in the 2008 presidential election. McCain's bold health care plan intended to decouple health insurance from employment.

Towers Watson's intentions should be applauded. There are many unknowns as the historic 2010 health care reform act rolls out, and the U.S. Department of Health and Human Services is clearly struggling with implementation.

The Towers Watson survey asked one of the most important questions out there: What effect will the health reform law have on employer-provided medical insurance?

That's critical, because most Americans under Medicare's eligibility age get coverage through their jobs. It's also important because the Affordable Care Act, perhaps to its detriment, builds upon the current system of employer-provided coverage delivered by private-sector insurers.

The law contains incentives (tax credits) and punishments (fines) to entice businesses to add coverage or continue it, but it's unclear if either policy carrot or stick is substantial enough to achieve these goals.

Towers Watson, however, seriously undermined its credibility by failing to ask another critical question: Would these same companies consider dropping coverage in 2014 and beyond if the Affordable Care Act were repealed? A good number would likely still say "yes."

Whether the ACA accelerates this trend remains an open question, but conflating the two is unfair. Other reports from the Congressional Budget Office and the liberal-leaning Urban Institute suggest roughly stable levels of job-provided coverage. Massachusetts, whose 2006 health reform is similar to the ACA, saw gains.

The Towers Watson survey isn't proof that employers will walk away from coverage because of the ACA. But it is unquestionably a reminder of the ACA's unknowns. The law emphasizes an evidence-based approach to medical care.

The same approach is needed to make sure reform improves the nation's pricey, ailing health care system.

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