Talk Health Reform

Keeping Employers In the Game?

Although the majority of Oregonians now receive health coverage through an employer, the overall trend is of an erosion of employer-sponsored insurance. Is this bad news or good? Should employers be in the business of offering health insurance to their employees, or should employed people get insurance some other way?

Oregon's Senator Ron Wyden has proposed a universal coverage plan that eliminates the employer role in the provision and payment of employee health coverage. Senator Wyden's Healthy Americans Act would disconnect insurance from employment, allowing health coverage to stay with people as they moved between jobs.  All employers would participate in the system by making payments to support premium costs for people up to 400% of the federal poverty level ($70,400/year for a family of three). 

Other national figures (including several presidential hopefuls) are proposing reforms that maintain employer participation.  States proposing reform are also mostly maintaining an employer role. Hawaii, which has had a universal health care access law in place since 1974, requires employer participation.  The Hawaii law requires all employers to offer health care coverage to employees working 20 hours or more a week (except seasonal employees). The employer must pay for at least 50% of the premium and the employee’s contribution can not be more than 1.5% of his salary.  To make such a law apply to all employers, Hawaii has an exemption from the federal Employee Retirement Income Security Act of 1974 (ERISA), something that no other state has received. Other states have made attempts to require employers to participate in health coverage.  For example, Massachusetts requires employer participation in employee health coverage, but the penalty for non-participation is low ($295 per worker per year). California's recently defeated proposal included employer participation requirements. The city of San Francisco has implemented an employer participation mandate.

Our current health insurance system relies heavily on employers to offer subsidized insurance to their employees.  Employer-sponsored health insurance has some advantages to employees and their employers.  For example, employers can pay for some or all of their employees' premiums.  Those contributions are a tax-deductible expense for the employer.

Should people who get insurance through their job be able to use pre-tax dollars to pay for premiums, while the self-employed or others purchasing in the individual market cannot get this tax advantage? Should we make tax advantages available to non-employed and self-employed people? What else should change, if anything?  If employers should be encouraged to keep providing insurance, what strategies do you think are the most important to maintain employer contributions to health care?

For more information on how Oregonians get their health insurance, see the report by the Office for Oregon Health Policy & Research on Health Insurance Coverage by clicking here for the pdf. For information on the national decline in employer sponsored coverage between 2001 and 2005, see this 2007 report from the Kaiser Commission on Medicaid and the Uninsured.

Health reform is happening. Weigh in.

Are you worried about health care?

Are you uninsured or afraid you might lose coverage or be priced out of the market?

Are you an employer struggling to afford health benefits for your employees?

If so, you’re not alone. Most Oregonians are concerned about health care. Only about one in three have a lot of confidence that they will be able to maintain their present level of health care coverage at an acceptable cost over the next five years. Right now, the Oregon Health Fund Board is working on a plan to ensure access to health care for all Oregonians.

Mandated by state law, this is a public process on a fast time line. How will it work? Will there be a requirement that everyone get insurance? Premium assistance for lower income people? Will universal coverage enhance or compromise the quality of health care Oregonians receive? Most importantly, how will health reform affect you and your family?

Here is your opportunity to weigh in! Voice your ideas and concerns. Raise a question. Hear from and respond to other Oregonians interested in health care.

And by all means, tell the Oregon Health Fund Board what you think should be done about health care. You can learn how to make a public comment to the Oregon Health Fund Board by clicking here. We welcome your comments here at talkhealthreform.org.  Comments made at this site are not considered official public comments to the Oregon Health Fund Board, but staff of the Oregon Health Fund Board are working with the Northwest Health Foundation to ensure that the discussions occurring here are shared with the Board and its Committees and Work Groups.

Welcome to talkhealthreform.org.  We hope you will share your ideas, thoughts and questions.  Your contributions will make talkhealthreform.org a great place to talk health reform and to help ensure that Oregonians get the best reform for all of us.