FALLING APART – Declining Job-Based Health Coverage for Working Families in California and the United States
UC Berkeley Labor Center and Working Partnerships USA Health Care
Policy Brief
June 2005
By Arindrajit Dube, Ph.D., Ken Jacobs, Sarah Muller, Bob Brownstein and Phaedra Ellis-Lamkins
To put it in context, the average growth in premium prices during the most recent period was 11% nationally and 13% in California.
If premium rates (in California) continue to rise 10% annually… Looking at the entire non-elderly population (adults and children) with incomes below 300% of FPL (the median American family income), more will be uninsured than have coverage through an employer by 2010, if current trends continue. Only 29% of individuals with incomes under 300% of FPL will have job-based coverage, 36% will be uninsured and 28% will have coverage through a public program.
Policy implications:
* Without major policy changes, employer-based coverage will continue to erode. – What used to be a fundamental component of the social contract for American workers across the income spectrum is now becoming a benefit enjoyed primarily by higher-income families.
* A continued decline in employer-sponsored insurance will shift additional health care costs from employers to the public sector, and increase the numbers of uninsured. – Unless immediate steps are taken to stem the decline in job-based coverage, significant new revenues will be needed to cover the increased demand for public health programs.
* Proposed cutbacks to Medicaid will jeopardize coverage for low-income adults. – Any cuts to public programs will threaten access to coverage for millions of low-income adults.
* Private insurance options are mismatched to those losing coverage. – Policies that rely on private insurance, such as individual mandates or health savings accounts, are mismatched to the economic realities of those losing insurance today.
http://laborcenter.berkeley.edu/healthcare/falling_apart.pdf
And…
Toyota to build plant in Canada – Nikkei
Reuters
May 29, 2005
Toyota Motor Corp. plans to build another plant in Canada, its seventh in North America… Toyota had considered building the plant in the United States but selected Canada because of lower labor costs, it said. Meanwhile, Toyota has started investigating suitable sites in the United States or Mexico for its eighth North American plant…
http://www.reuters.com/newsArticle.jhtml?type=businessNews&storyID=8637099
Comment: The opponents of national health insurance (NHI) have this one right. Policies designed to protect and expand our system of employer-sponsored coverage are doomed to failure because they fail to address the issue of affordability for employers, employees and taxpayers.
Even if the rate of premium increases dips below 10%, the decline in coverage for Americans below the median income level may not accelerate as rapidly as predicted in this study, but it will still continue. But the opponents of NHI would shift much of the financial risk to individuals, and on this one, they’re wrong.
So who is supporting the protection and expansion of employer-sponsored coverage? To no surprise, it is the incrementalists who believe that single payer reform is not politically feasible, and who believe that the only possible political path to universal or near-universal coverage is to expand on our current fragmented system of funding care.
Employer-sponsored premiums can be made affordable only by allowing employers and insurers to shift the costs of care away from the common risk pools and onto the backs of those individuals who need care, a disaster for both financial and health security. It is time to abandon the search for policies that would reduce premiums for private health plans!
Are we ready to start demanding policies that would ensure heath care access for everyone through affordable, comprehensive, universal coverage (i.e., NHI)? Or are we going continue to tremble about the prospect of political feasibility, as we drive around in our Toyotas from Canada and Mexico?
