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The House health care bill does numerous things that would strengthen the employer-based health care system, through which most Americans get their insurance. Most significantly, the bill contains strong provisions to ensure employers are responsible and offer good insurance to their employees [pdf].
Currently, many employers offer health care benefits, but some freeloaders don’t. The House bill makes it fair to all employers, and to employees. It’s only fair to ask employers – who benefit handsomely from healthy workers – to contribute to their employees’ health care [pdf], and the House bill does just that.
If you work at a large business (those with payrolls over $750,000 per year), your health care coverage will get better and cheaper:
- Employers will have to contribute at least 72.5% of premiums for individuals and 65% for families.
- Employer health benefits will have to conform to the essential benefits package [pdf]. This means that the coverage would provide for essential services (hospital, physician, prevention, maternity, prescription drugs, baby, mental health), eliminate out-of-pocket costs for preventative care, cap annual out-of-pocket spending, and prohibit annual or lifetime caps on coverage.
If your employer chooses not to offer you insurance, they will have to contribute to the Exchange based on the size of their payroll to help subsidize their employees, who will be able to purchase insurance through the Exchange. In this way, employers would have to either "pay or play," and share responsibility with the government and individuals for keeping everyone in America healthy.
If you work for a small business, which are exempt from the "pay-or-play" requirement, you may get health insurance for the first time (if your employer currently doesn’t offer it), or your insurance will become better and cheaper:
- Your employer can choose to purchase insurance for all its employees through the Exchange, or you can purchase insurance through the Exchange yourself, giving you the benefits package described above, as well as subsidies to help you afford it if you qualify.
- New rules will prevent insurers from charging more to small businesses if they have sick employees.
- Tax credits will be offered for two years to small businesses to help them afford good coverage.
Over time, bigger businesses will be able to buy into the Exchange, with automatic options opening in the years after the Exchange is set up, and the Secretary of HHS given discretion on whether to allow the largest of businesses thereafter.
The net effect is significant. Not only will you have access to coverage you could afford at work, but your coverage will be better. The House bill significantly strengthens the employer-based health care system, ensuring business and families can afford coverage, and good coverage at that. It expands the choices available to business, and it lets small business employees and potentially large business employees buy into the Exchange, where they can utilize the public health insurance option if they choose.
For those of us who get coverage through work – already the most stable and least costly of the insurance markets, especially the large group markets used by large businesses – this is welcome news.
(also posted at the NOW! blog)
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7 Comments
Thank you so much for explaining all this.
I am of the firm belief that health insurance should be detached from employment. It’s been grossly unfair for those who are not insured through work, and now it will be an added burden to employers as well. I can understand how health insurance tied to employment came to be — but that was over 60 years ago.
I would have set a date, say three months back, and had health insurance benefits changed over to wages -with a sensible tax adjustment. And then the pool of insurees is spread across all of the nation, all of the state, or all of the region.
But no one asked me. *pout*
I’m with Elliott.
And, there’s no real meaningful change to healthcare with the bills at hand in Congress.
Mandates for the masses, coverage subsidized for a marginal few million when MANY millions are either uninsured or under insured.
Giveaways for the insureance business, big med, big pharma.
It’s a funnel upside down, from taxpayer money, workers wages, to enrichen the fat cats of the 1%.
And HCAN is not much different than AHIP, on all of this.
Sorry Jason, but it’s a rigged game to further empty the wallets of the masses.
I call bullshit on it all. It’s not reform. Not at all. It’s a ripoff of the general public, yet again.
The reform being waged by congress and the lobby’s for med, ins and pharm (and AHIP and HCAN) is not reform. It’s legalized legislation to move wealth upwards and penalize and kill the masses.
What a crock.
“For those of us who get coverage through work – already the most stable and least costly of the insurance markets, especially the large group markets used by large businesses – this is welcome news.”
With this line alone, you sell out everyone below your class and station in life.
That’s a telling line, that line.
You show your belief in and support of the status quo, for the have’s.
And that’s not progressive, or liberal.
I’m real disappointed in that. Especially in this blog.
I don’t see it as an alternative voice either, I see it as a barrier and impediment to the goals that FDL and Mz. Hamsher has set, although far be it for me to speak for her and her blog.
So I’ll speak as a supporter of what I perceive FDL and Mz. Hamsher are doing.
I frequent this place because of like and kindred sentiments on many an issue. Both from the blog owner/mgmt and from most of those who post and comment here.
I don’t perceive HCAN, and now you, to be of like or in kindred with my sentiments.
And I don’t mind saying so.
And that’s my two cents.
US healthcare is certifiably insane. Craptastic. It’s as if the US was still using only black and white TV while the rest of the world has had colour for decades. “We’re number one! We’re number one!” —in delusion.
Why on earth would anyone want to strengthen an insane system like getting health insurance through employment? Am I missing something here?
(1) pay premiums for years
(2) get sick
(3) lose job
(4) lose insurance
(5) thanks for the cash, putz! now die.
Is that supposed to be a sick joke?
(no pun intended)
Black and white TV? Most European countries have had single payer since around the time TV was first invented. It’s like the US never got the TV and is still going with the radio all the while shouting “We’re number one!”
someone should have asked you.
imo the policy being proposed is idiotic neoliberal pro-corporate and anti-human rights. i’m astonished that not only is this what a democratic president, senate and house are proposing, i can’t believe progressives would support it — unless as a capitulation to the power of the corporations that have bought and paid for our gov. that is something to be mourned, not celebrated.
Stop pedaling this veal-pen crap. Employer based insurance is at the heart of the crisis. Employers hate to deal with it. Employees hate the paperwork and don’t trust it. Workers cling desperately to their jobs so they won’t lose it. It’s tremendously wasteful as it takes up a lot of HR time and personnel.
As usual, the only winners are the insurance co’s. This post is all about deck-chair re-arranging on the Titanic.
Take heart, true progressives. These phoney reform plans are not sustainable and will cause the crisis to fester. America will have to face up to the REALITY, the stubborn facts sooner or later. MEDICARE FOR ALL.
Well, Jason. I’m afraid you’ve gotten a pretty good sampling of sentiment here, and, guess what? It’s all negative.
I have the impression, and I guess other folks here share it, that HCAN made a decision to support this mediocre, and, in some ways immoral, House bill and now it’s trying to find ways of spinning and justifying this very bad bill.
I think the bottom line here is that the bill prioritizes deficit neutrality over the deaths of many thousands of Americans per year. Yes, I know the bill will reduce the 45,000 annual deaths by some substantial amount, but in the “band-aid” period before the exchange takes effect in 2013, we’re still looking at 31,000 or so deaths per year from lack of insurance. And, even after that at current death rates due to lack of insurance we’re still looking at 16,000 annual deaths. These likely forecasts suggests that the bill is a great failure.
We can, if we like, look at the bill from the perspective of how it compares to no bill at all. And compared to no bill at all, and, if we assume that we will have no bill over the next ten years, this bill is certainly an improvement.
However, whether or nor we have other bills, whether now, or next year, or any year in the future is our choice, the choice of Democrats, progressives, and the American people. So, the comparison of this bill with no bill at all is a false framing, narrowly circumscribing our choices and relieving us of responsibility to look at what we ought to have or what we might have had, or what we may have, if we fight harder.
There are bills we should have formulated, and bills that we can pass, that will not leave 31,000 annual deaths due to lack of insurance, and nearly as many health-related bankruptcies and foreclosures. There are bills that can virtually eliminate fatalities due to lack of insurance, and also bills that reduce the levels of these much more. So why isn’t the House bill like those?
The answer is that the bill’s number one priority is not solving America’s health insurance problem. It is, instead to pass a bill that legislators can say is deficit neutral. That is “deficit hawkism,” adhering to the ideology that prioritizes bringing tax revenues and Government expenditures into balance ahead of other far more essential national needs and priorities. In the case of health insurance and health care problems, adhering to that ideology is not only mistaken, or stingy, or an instance of false economy, but given that it accepts the inevitability of of hundreds of thousands of American deaths over te next decade, it is immoral. And its application in this legislation is also immoral.
Why isn’t health insurance reform in the bill made fully operative until 2013, since, if it were operative within a year along with subsidies that ensured that nearly everyone would get insurance, it would save more than 70,000 lives in the first 3.5 years? The answer is that it is Congress and the President placing the false standard of deficit neutrality over the next decade, above the moral imperative of ending fatalities due to lack of insurance.
The extent of immorality accompanying this choice is even more apparent, when everyone sees that we have not employed that standard to the bank and wall street bailouts, or to the Wars in Afghanistan, and Iraq. We prioritize some things above “deficit hawkism,” just not the lives of more than 70,000 Americans over the next 3.5 years, and 104,000 more over the next ten. looking at things from that perspective, the House bill, because of its enactment of a “band-aid” period of more than 3 years, and its provisions that don’t completely end lack of coverage after that, is both immoral and intolerable.