Industry insiders have been saying it for a while now — there could be a gradual shift toward consumer-driven health care through plan design and more options through private insurance exchanges. A new survey out this week from insurance researcher HealthPocket corroborates that idea, with 65% of employee respondents saying they’d like to select their health insurance company rather than have their employer choose. Conversely, only 22% said they’d prefer to leave the decision solely in their employer’s hands.

"The stage is set under ‘Obamacare’ for a decline in employer-sponsored health insurance and a rise in individually purchased coverage," says Bruce Telkamp, CEO of HealthPocket. "For those workers who will migrate from employer-sponsored to individually purchased health insurance, they'll get the control they desire."

However, the number of people who will shift from employer-sponsored care to the public exchanges remains uncertain. In fact, in Massachusetts’ implementation of their own health law back in 2006, the state actually saw an increase in the number of employees on their employers’ health plans, as Employee Benefit Adviser reported recently.

What could be a more likely scenario is the switch from traditional employer-sponsored insurance to private insurance exchanges. According to an Accenture report, private exchanges, which allow employers to give employees a choice of provider, will surpass enrollment in public exchanges by 2018. While many consumers have not yet heard of the concept, Accenture-compiled data suggests that 40 million people will be on private exchange by 2018, compared with 31 million on the public exchanges.

Dave Fear, Jr. is a broker in the Sacramento, Calif. area and thinks the HealthPocket poll makes sense as far as what he’s hearing from his clients right now, but he’s skeptical of private exchanges as an end-all solution. “Employees do like it, you get to choose what’s best for you and your family, but it typically comes at a premium,” the owner of Fear Insurance Services says. “In my area, CalChoice is an exchange that’s been around … for 21 years … and while it was a talking point that it would reduce costs, history has never shown that.”

Accenture finds that 83% of people do not know what a private exchange is at this time.

The HealthPocket poll was conducted in mid-July and results were cultivated from 781 responses.

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