Echoing long publicized trends identified by this newsletter, companies are getting more creative in how healthcare benefits are being paid.

At the same time, it is evident that much of the burden will fall on employees. At the same time, concern is growing about just how much of a burden employees can be expected to shoulder.

Four in five business owners (79 percent) who anticipate increases in their health care costs say they are concerned about their employees' ability to shoulder the projected increases.

The Robert Wood Johnson Foundation, in its just released survey report "Attitudes of Business Leaders Regarding Health Care Coverage," surfaced this concern, among others.

The survey of more than 600 business owners and benefits managers whose companies currently pay for at least some health insurance benefits shows companies of all sizes expect health care costs to jump an additional 12 percent over the next year.

Business owners surveyed say they will ask their employees to pay an average of 21 percent of the increase. Survey respondents estimate that their employees currently pay, on average, 29 percent of the cost of their own health insurance premiums—up six percentage points from 2003.

According to figures from the Kaiser Family Foundation and the Health Research Educational Trust—also just released—premiums average $10,880 annually for family coverage ($907 per month) in 2005, and $4,024 ($335 per month) for individual coverage.

"Business leaders know firsthand how important it is to offer health insurance, both because it improves the health of the workforce and because it makes their businesses more attractive to employees," said Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation.

"Small and mid-sized companies have long struggled to provide affordable health insurance for their employees, but now large companies with thousands of employees are finding it difficult to offer affordable health coverage. Our nation's leaders need to act on this issue before more and more working Americans find themselves unable to afford health care coverage."

To help small business owners identify and evaluate their health coverage options, a free, downloadable resource - the Guide to Health Insurance Options for Small Business - is available at http://www.CoverTheUninsured.org.

The survey was conducted by Public Opinion Strategies, Alexandria, Va., and has a margin of error of +/- 3.89 percent. It shows:

• Employers worry that their workforce may drop insurance because of rising costs. More than one-third (35 percent) of businesses that report an expected increase in health care costs say it is likely their employees would consider dropping their health care coverage because of this increase in out-of-pocket costs.
  
  
• Businesses are focused on affordability of health care. The goal of 'making health care more affordable' is a top priority among businesses, with half (53 percent) citing this as the most important health care goal that should receive the greatest attention in health care reform efforts.
  
  
• Business leaders support a range of policy proposals. Among a range of policy proposals tested, business owners and benefits managers expressed strong support for granting tax credits to small businesses that offer insurance coverage, and for allowing the self-employed and small businesses to band together to purchase insurance.

When asked which ideas would help "a lot" to increase the number of Americans with health coverage, business leaders responded:

• Allowing the self-employed and small businesses to purchase private health insurance at group rates. (53%)
  
  
• Providing tax incentives for small businesses to encourage them to provide health coverage to their employees. (41%)
  
  
• Enrolling more Americans who are eligible for government-funded health care programs. (27%)
  
  
• Expanding Medicaid coverage to include a greater number of lower-income Americans. (26%)
  
  
• Providing tax credits for low-income Americans to help them afford private insurance. (23%)
  
  
• Allowing Americans to set up tax-free health savings accounts. (21%)

"Businesses in America have a long tradition of offering comprehensive health care benefits to their employees, which is how most Americans receive health care coverage, but this practice is increasingly in danger," said Lavizzo-Mourey. "Large businesses are having to redefine the terms of their plans in order to keep offering benefits, and many small and medium-sized businesses are forced to stop offering coverage altogether."

The guide was prepared by the Robert Wood Johnson Foundation, in collaboration with the Healthcare Leadership Council and with guidance from the U.S. Chamber of Commerce, America's Health Insurance Plans, and the Blue Cross Blue Shield Association. The guide provides small business owners with key information on coverage—various plan options, tax advantages for providing employee coverage, tools to help estimate the cost of providing coverage, information on employee cost-sharing, and more.

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 30 years, the Foundation has brought experience, commitment and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. Helping Americans lead healthier lives and get the care they need—the Foundation expects to make a difference in our lifetime. For more information, visit www.rwjf.org.

Robert Wood Johnson Foundation, CONTACT: Becky Watt Knight, 202-745-5050, or Patrick McCabe, 202-745-5100.