Johns Hopkins Survey Reveals Hidden Dimension of Health Care Crisis

September 2, 2009 — Much of the attention in the current health care debate has focused on the impact of escalating health care costs on small businesses and the uninsured. But new data generated by the Johns Hopkins Nonprofit Listening Post Project reveal that health care costs are also producing a so-far hidden crisis for America's nonprofit organizations and the nearly 13 million workers they employ.

Virtually all (98 percent) of the responding nonprofits offering health benefits indicated that they are concerned about their organization's health care costs, and a striking 59 percent ranked health care costs as one of their organization's top challenges. The impact is already being felt in organizational decisions to stop offering, or reduce coverage of, health benefits, in higher employee co-pays and shares of insurance costs, and in pressures to hold down wages, shift to part-time employees, and even reduce mission-critical services.

The nonprofit workforce is the fourth largest of any U.S. industry. With generally lower pay scales, the nonprofit stake in health benefit costs is unusually high since nonprofit employers have historically relied on decent benefits to attract and retain quality staff. But with steadily increasing health benefit costs, that is no longer possible for large numbers of nonprofits, according to the July 2009 survey conducted by Johns Hopkins researchers.

"The evidence is now in," noted Lester Salamon, report author and director of the Johns Hopkins Center for Civil Society Studies. "Escalating health insurance costs are taking a dramatic toll on our nation's nonprofits and the devoted employees who work for them."

Other findings from the Johns Hopkins health benefits survey include:

*A striking 80 percent of the nonprofit respondents reported offering health insurance coverage for their employees. Nevertheless, the proportion not offering such coverage rose by 62 percent compared to the results from a comparable survey in 2004.