At a Glance | January 12, 2023 Employers Unlikely to Reintroduce Cost Sharing If Allowed. Savings Are Negligible. Plan sponsors are currently prohibited from imposing cost sharing for select preventive services and medications. A recent federal judicial opinion in Texas could change that. AT WHAT COST? Relatively Few Employers Would Impose Cost Sharing If Allowed by Law In addition to the potential negative clinical and equity effects of restoring cost sharing, 12% recent evidence suggests “It Depends” that the implementation of 8% 80% out-of-pocket costs on a select Would Not Impose of Employers Cost Sharing number of services would Would Impose Cost have a minimal impact (less Sharing If Allowed than one-half of 1 percent) on by Law aggregate employer health care spending. 8J8+8080+J 12+12 SELEC T SERV ICE S Preventive Services Usage and Savings If Coinsurance Reintroduced Our findings demonstrate that Annual Member Employer Savings From the incremental costs of Service Use of Service 20 Percent Coinsurance eliminating cost sharing are very 10% 0.11% Breast Cancer Screening low. Reintroducing 20 percent coinsurance would have a 9% 0.01% Cervical Cancer Screening minimal impact on overall employer health care spending. 4% 0.15% Colorectal Cancer Screening 3% 0.03% HPV Vaccination PRE V ENTI V E MEDICINE Usage and Impact of Coinsurance for USPSTF “A” and “B” Rated Medications on Employer Savings Preventive medications are similarly low cost. If employers Annual Member Employer Savings From imposed 20 percent cost sharing Medication Use of Service 20 Percent Coinsurance on these fully covered 9% 0.14% Contraceptives medications, employer spending would fall by just 0.3 percent. 8% 0.04% Statins (Ages 40–64) 1% 0% Breast Cancer Preventive Drugs (Ages 35–64) 0.2% 0.08% HIV PrEP Medication 17% 0.3% Total SOURCES: Fronstin, Paul, “The Impact of Covering Select Preventive Services on Employer Health Care Spending,” EBRI Fast Facts, no. 444 (October 20, 2022); Fronstin, Paul, “Will Employers Introduce Cost Sharing for Preventive Services? Findings From EBRI’s First Employer Pulse Survey,” EBRI Fast Facts, no. 445 (October 27, 2022). © 2023 EBRI This report is copyrighted by the Employee Benefit Research Institute (EBRI). You may copy, print, or download this report solely for personal and noncommercial use, provided that all hard copies retain any and all copyright and other applicable notices contained therein, and you may cite or quote small portions of the report, provided that you do so verbatim and with proper citation. Any use beyond the scope of the foregoing requires EBRI’s prior express permission. For permissions, please contact EBRI at permissions@ebri.org.