WASHINGTON -- The new healthcare law wasn't supposed to undercut employer plans that have provided most people in the U.S. with coverage for generations.
But last week a leading manufacturer told workers that their costs will jump partly because of the law. And a Democratic governor laid out a scheme to shift workers into taxpayer-subsidized insurance markets that open in 2014.
While it's too early to proclaim the demise of job-based coverage, corporate number crunchers are looking at options that could lead to big changes.
"The economics of dropping existing coverage is about to become very attractive to many employers, both public and private," said Gov. Phil Bredesen, D-Tenn.
That's just not going to happen, White House officials say.
"The absolute certainty about the Affordable Care Act is that for many, many employers who cover millions of people, it increases the incentives for them to offer coverage," said Jason Furman, an economic adviser to President Barack Obama.
Yet at least one major employer has shifted a greater share of plan costs to workers, and others are weighing the pros and cons of eventually forcing employees to buy their own.
"I don't think you are going to hear anybody publicly say, 'We've made a decision to drop insurance,'" said Paul Keckley, executive director of the Deloitte Center for Health Solutions. "What we are hearing in our meetings is, 'We don't want to be the first one to drop benefits, but we would be the fast second.' We are hearing that a lot." Deloitte is an accounting and consulting firm.
"My conclusion on all of this is that it is a huge roll of the dice," said James Klein, president of the American Benefits Council, which represents big company benefits administrators. "It could work out well and build on the employer-based system, or it could begin to dismantle the employer-based system."
Employer health benefits have been a middle-class mainstay since World War II, when companies were encouraged to offer health insurance instead of pay raises. About 150 million workers and family members are now covered.
When lawmakers debated the legislation, the nonpartisan Congressional Budget Office projected that it would have only a minimal effect on employer plans. About 3 million fewer people would be covered through their jobs, but they could get insurance elsewhere.
Two provisions in the new law are leading companies to look at their plans in a different light.
One is a hefty tax on high-cost health insurance aimed at the most generous coverage. Although the "Cadillac tax" doesn't hit until 2018, companies may have to disclose their exposure to investors well before then. A Boeing spokeswoman said concerns about the tax were partly behind a 50 percent increase in insurance deductibles just announced.
The tax is 40 percent of the value of a plan above $10,200 for individual coverage and $27,500 for a family plan. Family coverage now averages about $13,800.
White House adviser Furman said blaming a cost increase next year on a tax that won't take effect for eight years "stretches credibility very far past the breaking point."
Bigger questions loom over the new insurance markets, called exchanges, that will be set up under the law. Every state will have one in a few years. Consumers will be able to shop for coverage among a range of plans in the exchange, with a guarantee that they can't be turned down because of an existing medical problem. To make premiums affordable, the law provides tax credits for households making up to four times the federal poverty level, about $88,000 for a family of four.
Bredesen said last week that employers could save big money by dropping their health plans and sending workers to buy coverage in the exchange. They would face a fine of $2,000 per worker, but that's still much less than the cost of providing health insurance.
Employers could afford to give workers a raise and still come out ahead, Bredesen wrote in a Wall Street Journal opinion piece.
Employers are actively looking at that. "I don't know if the intent was to find an exit strategy for providing benefits, but the bill as written provides the mechanism," said Deloitte's Keckley.
A spokeswoman for the senators who wrote that part of the law says she's confident that when companies do the math, they'll decide to keep coverage.
If not, employers would lose the deduction they now receive for the cost of workers' healthcare and would face higher costs for Social Security and Medicare taxes.