Should The Employer Mandate Survive?

Over the period January 8th through the 11th of last week the Morning Consult conducted a poll of 1,707 registered voters to understand their views regarding the Employer Mandate. The reported responses have a margin of error of +/- 2.4% (I assume that’s at 95% CI). What they found seems a bit counterintuitive at first. But it may reflect an indication of where we sit along the curve to better understanding the economics of healthcare in the United States.

Of those polled, 74% believe that a 40-hour workweek should constitute full-time employment – not 30, the definition used as part of the Affordable Care Act’s employer mandate provision. But only 58% support Congress’s effort to legislatively change that definition. Why? Dunno. And yet, 57% of respondents overall support the employer mandate provision of the Act, and 55% believe companies should provide healthcare for part-time employees.

Whether employers are required to provide health insurance for their workers at 20, 30 or 50 hours misses the broader discussion of whether the employer mandate still makes sense in light of other provisions of the Act having been enacted. And it misses the political discussion of whether it’s a reasonable and plausible giveback to a Republican Congress that’s carried around the repeal and replace bone long enough.

Even the most ardent opponents of the ACA have to admit, if they are being honest, the past few years have increased the individual and social consciousness of healthcare as a very real – and very expensive – commodity that has been more misunderstood than any other product or service in history. And despite the major early challenges of the insurance exchanges most indications now support the dawning of a new dynamic in financing healthcare delivery: the expansion of individual insurance and responsibility.

Ever since wage freezing during WW II led employers to use healthcare benefits in seeking competitive advantage recruiting workers the disconnect between what individuals pay out of pocket for healthcare – and what healthcare actually costs to produce – has been an underlying source of tremendous waste and inefficiency. Have the exchanges, coupled with the incremental increase in Medicaid expansion, made the employer mandate concept moot – or worse, an economic albatross that could stifle growth at a time when the country just might be turning a corner?

What do you think?

Cheers,
  ~ Sparky

 

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