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Health Care Reform:

Health Insurance & Affordable Care Act

Affordable Care Act: How Employers Change Coverage

3. You Might Have to Buy a Policy From a Private Exchange

Other companies are trying a similar approach to Trader Joe's, but without sending employees to the new Marketplaces. Instead, their employees will get insurance through a similar system that's not managed by the government.

One example: The Walgreens drugstore chain is moving its workers to a private Exchange, a kind of shopping mall of insurance options. Walgreens will still provide financial help, and it says the system will give most employees a chance to save money in the long run.

Is this a positive trend? It depends on how well the health care reform law succeeds at controlling health care costs, says Wendell Potter, senior analyst at The Center for Public Integrity. Still, he says, the path forward is clear: "You'll see more employers giving their employees a certain amount of money and sending them to Exchanges that are public or private. They'll save money by capping their contributions, and they'll be more in control of their health care spending."

4. You Might Get Downgraded to Part-Time

Employers might try shifting workers to fewer than 30 hours a week so they won't get health coverage, Buchmueller says. "Some will look hard at this. However, some of them will conclude that the productivity cost of reconfiguring their workforce outweighs any savings from not offering those workers insurance."

5. You Might Lose Coverage Entirely

Could your employer decide to simply stop providing health insurance benefits? It's possible, although it's not a new phenomenon.

"Over the past decade, probably longer, fewer people who have insurance have gotten it through the workplace," Potter says. "And more smaller employers have gotten out of offering coverage. More are saying, 'I just can't afford that.'"

The good news: Buchmueller says large employers aren't likely to cut off coverage if they haven't already. "Most workers in the U.S. work for large firms, and they're mostly voluntarily providing coverage," he says. "Starting in 2015, there will be a penalty for not offering coverage. If they haven't dropped it at this point, there will be less reason to do so going forward."

For many companies, good health care coverage remains an important recruiting tool for finding and keeping top employees.

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