The Future Of Health Insurance | Can employer-based health coverage continue?
For most people with good, full-time jobs, health insurance is a key part of how they think about employment: How good is my new employer’s plan? If I switch jobs how long can I afford a COBRA? Would I be better off on my spouse’s plan?
But a recent report by the liberal-leaning Economic Policy Institute suggests that fewer people have the luxury of those sorts of worries. Nationwide, the report says, between 2001 and 2007, the percentage of people under 65 covered by an employer’s plan dropped from 68.3 percent to 62.9 percent. During those six years, it says, the ranks of both the uninsured and those covered by government plans rose.
Massachusetts Mavericks
In Massachusetts, the story has been a little different, at least for the past couple of years.
According to state data, enrollment in employer-sponsored plans rose by 159,000 between June 2006 and March 2008, thanks largely to the state’s experiment in moving toward universal coverage. Meanwhile, enrollment in government-sponsored insurance rose even faster, and the numbers of uninsured dropped.
But for many local businesses, and their employees, the situation here is far from ideal.
Susanne Morreale-Leeber, president and CEO of the Marlborough Regional Chamber of Commerce, said many chamber members’ employees have signed up for their plans since the state started requiring residents to buy insurance.
That may be a good thing in some respects, she said, but with a typical 50-50 split of premiums between employers and employees, it’s expensive for everyone involved.
“I’m hearing that, unfortunately, it’s almost like a budget buster,” she said.
In fact, with insurance costs rising all the time, she said, some employers tell her that when a worker decides to take the company insurance plan the extra cost may mean the difference between hiring another employee and leaving a position vacant.
Dan Amason, the insurance administrator for the North Central Massachusetts Chamber of Commerce, said that some employers are reducing the quality of the plans they offer. And he said some in the construction industry, which is being simultaneously hit by a severe downturn, have actually laid off all their workers, preferring to do the work themselves or use subcontractors.
The Politics Of Policies
All this has some people talking about radically different ways of offering health care.
Sen. John McCain’s health care plan would essentially gut the employer-sponsored system by dropping the tax protections now in place for the plans.
Many individuals would be left to buy their own plans on the open market, with a tax credit to help them out. But opponents of the plan argue that the older, sicker people who need insurance the most would almost surely be unable to buy insurance that way.
McCain would provide $7 to $10 billion to subsidize coverage for high-risk people, but an analysis by the peer-reviewed health policy journal Health Affairs says that’s nowhere near enough to cover those who would need it.
Meanwhile, depending how you ask, polls show a majority of Americans would like to see a single-payer system that would extend Medicare-style coverage to everyone.
No one in the political mainstream is pushing that idea, probably partly because it would face unbelievably fierce opposition from the insurance companies. (Sen. Barack Obama’s plan is much closer to the Massachusetts model.)
But if trends continue the way they are, the country’s choice may come down to that kind of all-for-one-and-one-for-all plan or a McCain style every-man-for-himself approach.
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