Employers Create ‘Barriers’ to Health Coverage, New York Times Columnist Says

While the best way to obtain health insurance under the current system is to be "gainfully employed by a company that offers coverage," Jennifer Steinhauer writes in a New York Times column that there are many "hidden barriers" to employer-sponsored coverage. Steinhauer says that company eligibility policies as well as high premiums often "discourage ... workers from getting insurance." In addition, companies sometimes raise the amount of the premium that employees must cover, Steinhauer notes, pointing to a recent Commonwealth Fund study that found that "even a small increase" can cause workers to "change or reduce" coverage. The study also found that "tight restrictions," including "exclusions" for pre-existing conditions and waiting periods, keep many workers from enrolling in employer-sponsored plans. In addition, Steinhauer says that an "absence of choices" may "discourag[e]" some workers from enrolling in health plans; about 87% of workers in small firms have access to only one health plan, typically an HMO. Steinhauer also notes that some companies, unhappy with "having to administer benefits and fight with insurance companies," are "often low-energy advocates" for their employees in coverage disputes with a health plan. With the restrictions and high cost of some employer-sponsored plans, Steinhauer writes that it becomes "cheaper and more attractive" for some workers to decline coverage and pay out of pocket when they become ill. Further, some employees decline coverage to "keep their bosses out of their personal business." Many health policy experts contend that universal health care or medical savings accounts are "better solutions" for increasing coverage for the "uninsured and underinsured" than employer-sponsored coverage. But Steinhauer concludes that since employers have a role in providing coverage "for now," they "could do more, sometimes at little extra cost, to increase the percentage of insured workers in their midst" (Steinhauer, New York Times, 8/19).