dumping employer health care

NEW YORK, Sept 9 (Reuters) - As many as 37 million Americans who receive health coverage through employers may be better off with the government-subsidized insurance plans that will be offered under President Barack Obama's healthcare reform law for next year, according to a study released on Monday.

The analysis, compiled by researchers at Stanford School of Medicine and published in the journal Health Affairs, suggests that some employees may choose to dump the coverage they receive at work. It also points to a potential counter-trend to surveys of employers, which show that up to 30 percent would consider terminating health coverage for their workers within the first few years of "Obamacare."

"There is definitely going to be some pressure in that direction," said Thomas Buchmueller, a professor of insurance at the University of Michigan's Ross School of Business, who was not involved in the study.

"Workers could say, 'we appreciate that you offered us coverage all these years, but we'll be better off on the exchanges, so give us the cash and we'll go.'"

That scenario, which would cost the federal treasury billions of dollars above what it has already projected, reflects the complicated financial carrots and sticks at the heart of Obama's 2010 Affordable Care Act (ACA).

On the one hand, it requires large employers with 50 or more workers to offer health insurance or pay a $2,000-to-$3,000 annual penalty per full-time worker. About 170 million Americans have health insurance through their own job or through a family member's; such coverage is available to 80 percent of full-time workers.

On the other, the law allows workers to buy coverage on new state-based exchanges and receive federal subsidies to help pay the premiums and deductibles, if their employer-sponsored insurance is deemed unaffordable according to a government calculation.

Roughly "37 million people would be financially better off switching to the exchange" from employer-sponsored insurance, said Dr. Jay Bhattacharya of Stanford School of Medicine, who led the study.

"The reason is that these workers would qualify for substantial subsidies to buy exchange insurance," he said. As a result, the subsidized Obamacare premium will be less than what they pay for employer-based insurance. The cost to the federal treasury if all 37 million switch: $132 billion a year in subsidies, according to the study.