Health Care For America Now

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.