Delinking Health Insurance from Job Must Be Top Priority

From the Economic Policy Institute (http://www.epi.org/):

Since the onset of the COVID-19 pandemic, more than 12 million people have likely lost their employer-sponsored health insurance.

The inefficiencies and problems caused by the U.S. system of tying access to health insurance to specific jobs are well known. The downsides of employer-based health insurance access have been made spectacularly visible by the COVID-19 shock—a shock that has cost millions of Americans their jobs and subsequently their access to health care.

An EPI report authored by Josh Bivens and Ben Zipperer made clear that delinking health insurance from holding a job must be a top policy priority. The report reveals that during the pandemic, 6.2 million people lost employer-sponsored insurance. Because these plans also often covered partners and dependents, this translates into roughly 12 million people losing their access to health insurance.

The most ambitious and transformational way to sever this link is through a “single-payer” style health care plan, which would pave the way to giving U.S. workers, and our economy, a boost, as explained in this video. But any movement to expand public insurance and delink jobs and health care coverage would be a strong move in the right direction.

The federal government already is the primary insurer for all Americans over the age of 65 and for households with incomes low enough to qualify for Medicaid. The advantages of large public insurance systems are important, both in ensuring consistent access to medical providers that households prefer and in restraining the often-rapid growth of health care costs.

What are the next needed steps in health reform?

Absent a once-and-for-all switch to something transformational like Medicare for All, policymakers can take a number of smaller steps to delink health insurance from specific jobs by expanding public options for insurance coverage. They could lower the age of eligibility for Medicare, raise the income thresholds for Medicaid eligibility, or create a public option in the Affordable Care Act. Alternatively, lawmakers could require employers either provide comprehensive and affordable insurance or pay a fee to help cover the costs of enrolling their workers in the public option.

Finally, to address the current COVID-19 crisis, the federal government should pay all expenses for COVID-19-related testing and treatment. Given the historically rapid increase in uninsurance in the first months of the COVID-19 shock, policymakers should also allow all those without insurance to enroll in Medicaid, regardless of income, for the duration of the crisis.

Since most U.S. workers rely on their employer or a family member’s employer for health insurance, the shock of the coronavirus has cost millions of Americans their jobs and their access to health care in the midst of a public health catastrophe. Tying health insurance to the labor market is always terribly inefficient and problematic, but becomes particularly so during times of extreme labor market churn.

The COVID-19 shock has exposed just how incomplete and threadbare the U.S. health care and social insurance system is. Together, we must build a better health care system that provides security to all.

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