Ensuring Affordable Health Coverage for All (continued)

The American Health Choices Plan will make health insurance more affordable for the millions of Americans who want it. It includes a number of straightforward policies to achieve this end:

3) Promoting Shared Responsibility for Large Employers: Hillary Clinton's comprehensive agenda to lower costs and improve quality will substantially lower costs for employers, making it easier for all firms to continue coverage or offer new health benefits to their workers. In return, large employers will be expected to provide health insurance to their employees or make some contribution to the cost of coverage. This responsibility will take into account firms' size and average wages.

Since I covered my thoughts on the above a few blogs back in "Group Hug" (click here), I have nothing further to add.

4) Creating Small Business Tax Credit: Small businesses are engines of job growth in our economy. They account for 80 percent of net new jobs since 1990xvi and create jobs that stay here in America. Yet, they also face the most acute challenges to providing health care for their employees. Small businesses face higher premiums due to limited purchasing power and tend to employ lower-income workers. xvii  As a result, small employers cover far fewer of their employees - and the proportion that offers coverage in the first place is less than half that of large firms that offer health insurance. Coverage among small employers is eroding. Since 2000, the share of these small firms offering coverage has fallen from 57 percent to 45 percent. xviii At a time when health care costs are increasingly undermining the economic competitiveness of American business, Hillary Clinton's plan seeks to make it easier - not harder - for small businesses to create new jobs with health care for workers here in the U.S. Specifically, small businesses that provide quality coverage (e.g., benefits like what Members of Congress receive) and contribute most of the premiums for their workers would qualify for a refundable tax credit. The tax credit could be structured as a traditional policy (e.g., a credit equal to 50 percent of premiums for firms with fewer than 25 employees and less for medium-size employers). As President, Hillary Clinton would work with the small business community and Congress to design the parameters of the credit (e.g., protecting against subsidizing boutique high-income firms) as well as how the credit might dovetail with the tax credit going to individuals and families to make premiums affordable.

xvi. Kelly Edmiston, Federal Reserve Bank of Kansas City, 2007.

xvii. Len Burman, "Taking a Checkup on the Nation's Health Care Tax Policy: a Prognosis," Testimony to the Senate Committee on Finance, March 8, 2006.

xviii. Kaiser Family Foundation / Hospital Research and Educational Trust. (2007). Employer Health Benefit Survey: 2007. Menlo Park, CA: Kaiser Family Foundation

As I continue to go through this plan, part of me thinks we need to start thinking about  ways to aggregate health insurance outside of the workplace.  Why must we rely on employers to create the groups that spread the risk related to insurance?  Just because a company is big or small doesn't really, in my mind, make it a perfect candidate for providing insurance.