The Employer-Sponsored Health Insurance System at a Crossroads

In the United States, we are used to our health insurance coming from our job. However, this connection also means losing or changing your job can result in significant health care coverage changes as well, including loss of your insurance. Even before the COVID-19 pandemic, this 75 year old structure was under stress as unsustainable costs for small and large businesses and crippling out-of-pocket expenses for patients have increasingly forced those seeking medical care, even when they have insurance, to ask the question, “can I afford to get care?” rather than, “how do I access the right care for me?” Now, in the midst of a historic pandemic, the deficiencies of the system are laying bare the interconnectivity between our personal access to affordable health care, our financial and job security and each other. This brief examines:

• How American employees came to rely on employers for their health insurance coverage
• The tremendous financial strain this system places on the federal treasury, individual employees, state governments and America’s largest businesses
• How the tax code treats job-connected health insurance AND provides deeper discounts to those who earn more income
• How some state governments have attempted to mitigate the extraordinary costs of health insurance coverage
• How 3 of America’s largest businesses have worked to balance both the ballooning costs of providing their workers with health insurance and the imperative to retain a healthy and satisfied workforce
• The complex shared-role between state governments and Congress of regulating this space which slows public policy progress

USofCare wants to be part of the solution and our goal is to begin a national conversation about the common burden of this paradigm between employees and employers, how the complexity of this system is not serving people and how it hinders American business innovation and entrepreneurship. We will bring together policy experts, employers, innovators and people experiencing our health care system to understand what currently works and what alternatives could look like. Our current job-based system has been in place for decades, and now it is time to think about a system that can give people health care coverage security they want no matter what life may bring.