Through expanding Medi-Cal and subsidizing private insurance through Covered California for 1.3 million Californians, the Affordable Care Act (ACA) launched the triple of aim of better access, improved care, and reduced costs. As the ACA enters its third year of implementation, California will need to look beyond coverage expansion and evaluate strategies and policies that advance the triple aim framework for employment based health insurance. California’s policymakers and the employer community will need to work together to address needs and challenges that include:
- Improving coverage and affordability within the different employer markets (small, midsize, and large)
- Implementing payment and delivery system reforms that reward value
- Preparing for the impacts of the Cadillac tax
- Considering the merits of insurance market mergers.
This report provides background history and key findings from the literature and the latest available survey data on employer health benefits, describes the California context, and outlines issues for policymakers and employers to consider in advancing the triple aim for employer-based health insurance.