January 15, 2010

Health Affairs - Health Policy Brief: Congress is negotiating final details of proposed requirements that employers pay a substantial share of their employees' health insurance or subsidize coverage of the uninsured

The Robert Wood Johnson Foundation writes in this brief that employers currently provide health insurance coverage to almost three in five Americans under age 65. As such, employment-based coverage is considered the bedrock of America's health insurance system. But not everyone with a job has health insurance. In 2006, nearly 13 percent of full-time workers had no health insurance at any time during the year. Two-thirds of the 46 million nonelderly people without coverage in 2008 were in families with one or more full-time workers. To shore up the system of employment-based health coverage, and to extend coverage for those not now insured, many health policy experts have long argued for requiring employers to contribute to coverage for their workers. Such measures are known as "employer mandates" or, more recently, "shared responsibility" requirements on employers to help provide coverage. The health reform bills passed by both houses of Congress would require most large employers either to pay a share of the cost of their employees? coverage or to pay a fee to help subsidize coverage for the uninsured. Some opponents of an employer mandate believe that employment-based insurance is an anachronism and should be replaced with a health insurance system that is more individual-oriented, portable, and in tune with the flexible and dynamic modern economy. Others, such as the U.S. Chamber of Commerce and the National Federation of Independent Business, oppose argue in particular that the burden of mandates falls on employers and would raise costs for many companies already harmed by the current economic downturn.