In recent days, there has been some confusion about the ability for businesses and insurance plans to receive blanket waivers from following the new consumer-focused rules of the road in the Affordable Care Act – the health reform law. As we continue to move forward with implementation, and work with the business community, insurance industry, state leaders, consumers and everyone else with a stake in improving our health care system, it is important that we set the record straight.
Here are the facts:
Today, over 165 million Americans get their health insurance through an employer—comprising nearly 70 percent of America’s insured population. Employers offer health insurance as a way to attract the best and brightest candidates in the work force. Employer-based insurance is the most common and efficient source of insurance coverage, which is why the Affordable Care Act takes steps to strengthen the employer-sponsored insurance market and make it easier and affordable for businesses to offer coverage to their workers.
However, not all coverage offered by employers is the same. Employers who hire full time middle to high income workers tend to offer more comprehensive plans that cover essential health benefits (hospital care, physician visits, preventive services, among others) and provide sufficient security against financial risk of illness and accidents for their employees. These employers offer more comprehensive coverage because workers are more likely to be able to pay their share of the premium. Workers at these firms are also more likely to work at the company for an extended period of time, making it good business sense for employers to invest in their workers’ long-term health since good health is linked to increased productivity. The law ensures this system continues, while helping to lower health care costs and providing financial support for employers who offer coverage to their retirees too young for Medicare through the Early Retiree Reinsurance Program.
Unfortunately, many workers don’t have this kind of quality coverage. Employers who hire lower wage, part time or seasonal workers are more likely to offer limited benefit plans. Retail or chain restaurant employers frequently offer limited benefit plans that contain less comprehensive coverage and annual dollar limits on how much workers can receive in health coverage. The premiums for these limited benefit policies (known as mini-meds) are significantly lower than for policies with comprehensive coverage and are more affordable for lower wage workers and their families. In exchange for the low premiums, these policies generally come with high deductibles and annual dollar caps as low as $2,000. In addition, in many cases, employees are paying the full cost of the insurance policy, with no help from their employer.
Fonte: White House