Conventional wisdom holds that employers are a monolithic block of opposition that is against any form of “Medicare for All” or national public option.
Although this is true of the U.S. Chamber of Commerce and other lobbying groups representing larger employers who view healthcare coverage as an important offering to attract and retain talent, it may not extend to smaller employers, according to a KHN article published June 7.
KHN profiled small- to mid-sized employers who have joined labor unions and consumer groups in favor of Medicare for All. Despite concerns of the tax implications of Medicare for All, the article cites the complexity of having to understand health policy to make an informed purchasing decision and an inability, despite experimenting with narrow networks, HDHPs and wellness efforts, to control premium growth as the overriding factor. The employers interviewed also express frustration that health plans and brokers have been largely ineffective advocates for purchasers.
Takeaway
Given the complexity of healthcare and employers inability (or unwillingness) to tackle healthcare costs, it’s surprising they aren’t more supportive of at least a public option for their older, more expensive workers.
However, I suspect that if struggles to control costs continue, we may see more employers change their position.
The support of small to mid-size employers for Medicare for All may increase the likelihood of passage of something along the lines of Senators Tim Kaine (D-Va.) and Michael Bennet’s (D-Colo.) Medicare X bill, which would eventually allow a public option to compete in the SHOP (small business) exchanges.
However, barring some unforeseen event or collection of events, it’s difficult to imagine movement on this before 2024, at the earliest, due to the current composition of the Senate and the 2020 senatorial race map. So, the industry still has some time to come together and work collectively to reduce the total cost of care and allow those reductions to translate into reduced premium growth.
