Idea of the Day: Improving the Employer Market for Health Care

April 27, 2009

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Health care reform means reducing the crushing burden of rising health care costs on America’s families, businesses, and governments at all levels, while ensuring that everyone has reliable, meaningful, affordable health coverage. Likewise, this kind of reform must assure access to affordable, meaningful coverage for all workers who obtain health coverage through their employer, which in some circumstances may be outside of the national insurance exchange.

Congress may wish to consider exactly how health reform addresses the gaps in the employer market so evident today. Guaranteeing adequate, affordable coverage for all Americans regardless of where they obtain their health insurance is a key component of health reform. Health care reforms that establish fundamental inequities between a national health insurance exchange and the employer-based health insurance market—the source of most Americans’ health insurance today—will ultimately compromise our efforts to fix our broken health care system. Therefore, as Congress moves forward with reform legislation, it should keep in mind three basic principles for improving the employer market:

First, make sure that American families can access health care whether they obtain their coverage inside or outside the exchange. Basic consumer protections should apply to all health insurance, whether the policy originates from the insurance exchange, an employer-purchased policy, or a self-insured employer plan.

Second, health coverage should be adequate and affordable inside and outside the exchange. Many employers who offer health coverage will be able to meet the benefit and affordability standards that apply within the exchange.

Third, consider additional options for vulnerable workers. All workers should have access to affordable coverage, but low-income workers should have additional avenues for enrolling in coverage that works best for them. By enabling these workers to obtain coverage through the exchange—even though they work for large employers who do not participate in the exchange—Congress can improve these workers’ overall financial health and well-being.

For more on this topic, please see:

• Assuring Access to Employer-Provided Health Coverage by Karen Davenport