>>It shouldn’t be, there should be a way to properly decouple employment and healthcare.
>It's really simple, remove the tax benefit from employers purchasing health insurance... and employer plans and whatnot would be outlawed.
How do you get from here to there without it turning into a boon for certain employers at the expense of their employees? That is, how do you ensure that the money currently paid in benefits is passed along to employees to purchase their own plans and not pocketed (partially or in total) by companies.
One way would be to allow companies to pay employee's healthcare premiums on the employee's behalf. That's almost like the current system, but still decoupled:
1. Employee buys their own plan from healthcare.gov.
2. Employee can choose to pay directly, using pre-tax dollars. Tax law is changed to that healthcare premiums are deducted from AGI for everyone who pays them.
3. Employee can choose to submit plan documentation to employer, who will pay some/all of the premium on the employee's behalf. In this case, employer gets the tax break. If only partially paid, employee pays the rest and gets to deduct that portion.
Financially, it's a wash either way. It gives the employee control over their health plan, and it changes the 'perk' status of employer-paid healthcare. It also gives time for employers to transition away from the "reduced salary + healthcare premium" model, because they'll be competing with employers who pay higher salary and no healthcare premium. Many employees will probably prefer the higher salary, because it's more flexible and feels better. That transition can occur over time without disadvantaging any employees, because the overall costs and tax implications are the same.
That will be forced to happen as people will need to purchase insurance and demand more pay.
If anything, people will have mobility to move to different jobs and the ability to actually see which job pays more or less, so employers will have to actually compete.
And half the people the US already don’t get health insurance from employers.
>It's really simple, remove the tax benefit from employers purchasing health insurance... and employer plans and whatnot would be outlawed.
How do you get from here to there without it turning into a boon for certain employers at the expense of their employees? That is, how do you ensure that the money currently paid in benefits is passed along to employees to purchase their own plans and not pocketed (partially or in total) by companies.