The Cost of Spousal Health Coverage, p. 2 The Role of Social Security, Defined Benefits, and Private Retirement Accounts in the Face of the Retirement Crisis, p. 8

As of 2012, 7 percent of employers did not cover spouses when other coverage was available to them and 4 percent of employers with 1,000 or more employees reported not providing such spousal coverage. As of late 2012–early 2013, another 8 percent of large employers were reporting that they planned to exclude spouses from coverage when other coverage was available. A recent decision by United Parcel Service to eliminate health benefits for spouses who were eligible for coverage through their own employer may be a tipping point in employment-based health benefits, in part due to provisions in the Patient Protection and Affordable Care Act (PPACA). This study documents that spouses, on average, cost more to cover than otherwise comparable policyholders. This, in conjunction with the latitude offered by PPACA, makes spousal coverage a target for employers seeking ways to lower their health care expenditures. However, this analysis finds that working and non-working spouses are likely quite different in their use of health services. Therefore, the strategy of not covering spouses who are employed may have unintended consequences for employers