Affordable Health Insurance Struggles For Employees Without Reform?

For months, healthcare reform was considered an inevitability. The Republicans regaining their ability to filibuster legislation in Congress has changed all that. Now, Democrats and others must consider what will happen if their bills are removed from life support. The House of Representatives and Senate have both passed bills that sought expand access to affordable health insurance to millions of uninsured Americans. However, the House considers the Senate's version unacceptable, and the arcane budget reconciliation process--which would allow senators to pass a modified bill with just 51 votes--is too politically untenable.



Understandably, the public is skeptical of the Obama administration's far-reaching proposals. Full-fledged healthcare reform is especially daunting when people are facing so many other changes, including unemployment. Republicans have just begun to offer their alternative policies, but they are likely to reach a similar standstill. Democrats want the current bills to be a starting point for negotiations, not trusting that the minority party is serious about providing affordable health insurance; meanwhile, Republicans are angry that the Capitol Hill majority appears to be ignoring them.



Even with more people out of work, the majority of Americans still receive health insurance through their employers. The majority of them even express satisfaction with their plans, and fear that healthcare reform would have a negative impact. Some analysts predict that left unabated, those plans will nevertheless deteriorate in quality.



The trend has been towards increasing healthcare costs. In 2009, spending was $2.5 trillion (counting both public and private health care spending), and it has continued to grow at a rate higher than inflation. Employers have been shifting a higher portion of costs onto their employees: the average co-payment and deductible has gone up in recent years. Certain employers have even changed their plan offerings to save money: for example, eliminating a comprehensive HMO plan in favor of a scaled-back high-deductible health savings account (HSA) plan. This will be especially inconvenient for older workers with pre-existing conditions, who will have to shoulder more of the cost of care.



As proposed by Democrats, healthcare reform would provide subsidies to some small employers, many of whom currently do not offer it. If current trends continue, experts believe affordable health insurance for employees may become more scarce. More low-wage employees earning too much to be eligible for Medicaid may become uninsured, and companies with a large percentage of workers in that income bracket may follow the lead of Wal-Mart and not offer affordable health insurance.



Without the government's involvement, there are predictions that corporate (rather than federal government) bureaucrats will take more control over their employees' health in order to reduce their costs. More companies will begin to monitor their workers' lifestyles, offering relatively affordable support while penalizing those who fail to maintain a healthy weight or quit smoking with higher premiums. Whole Foods presents an example of this, including the incentive of lower premiums for those who meet the health guidelines. Maybe encouraging lower rates of smoking and obesity will end up reducing the cost of health insurance, lowering premiums and the uninsured population without reform. Large corporations, meanwhile, were hoping to use the potential changes of Medicare as a guinea pig to test possible changes to their own insurance.



(Image: DeaPeaJay under CC 2.0)



Yamileth Medina is an up and coming expert on Health Insurance and Healthcare Reform. She aims to help people realize that they can find affordable health insurance right now. Yamileth lives in Miami, FL.