Jan 21, 2020

Employers, not patients, have the most health insurance choices

Illustration: Sarah Grillo/Axios

Most people don't have nearly as much choice over their health insurance plans as Republicans and moderate Democrats sometimes suggest.

Between the lines: People who get their insurance from their employer — the majority of people with private insurance — are often given few plans to choose from, if they're given any choice at all.

What they're saying: This came up in former Vice President Joe Biden's interview with the New York Times' editorial board.

  • "If you like your plan, you can keep it, assuming — I should add the obvious — if your employer doesn’t take it away from you."

The comment is a nod to how much control employers have over their employees' health insurance.

  • Many workers are presented with just one plan option, meaning they don't have any choice at all. Others will have multiple plans, but all from the same insurance company.
  • Employers frequently shop around for better deals, but employees are stuck with choosing between the limited choices their employers present to them.
  • And while competition is improving in the individual market, most people who buy insurance on their own still have only a handful of insurers to choose from.

Biden has proposed a public insurance plan that would be open to people with employer-based insurance — which experts say could lead to some employers deciding not to offer their own coverage.

  • For workers who have generous employer coverage now, a public option with limited provider participation would probably be a bad deal.
  • But if most doctors and hospitals participate in the public option, workers may not end up with any fewer choices than they have now.

Between the lines: "In the current political debate, choice has mostly been about whether you can choose private insurance or a public Medicare-like plan. But, that in many ways obscures the choice that probably ultimately matters to most people, which is choice of doctor or hospital," the Kaiser Family Foundation's Larry Levitt said.

Go deeper: Employers aren't changing their health benefits

Go deeper

Democrats like both Medicare for All and a public option

Data: Kaiser Family Foundation survey of 1,212 U.S. adults conducted Jan. 16–22, 2020. Margin of error ±3 percentage points; Chart: Axios Visuals

While Democratic presidential candidates are deeply divided between Medicare for All and a public insurance option, Democratic voters seem to be cool with either one, according to a new Kaiser Family Foundation poll.

The big picture: Sizeable majorities of both Democrats and independents in the Kaiser poll said they approve of a single national health insurance system, and larger majorities said they like the idea of a public program competing alongside private insurance.

Go deeperArrowJan 30, 2020

Health care prices still rising faster than use of services

Photo: Ricky Carioti/ The Washington Post via Getty Images

Employers, workers and families continued to spend a lot more on health care in 2018, but that wasn't because people used more services, according to the latest annual spending report from the Health Care Cost Institute, which analyzes commercial health insurance claims.

The bottom line: Higher prices remain the main culprit for exploding spending among those with private health insurance.

Go deeperArrowFeb 14, 2020 - Health

AOC concedes Sanders may have to compromise on Medicare for All

Ocasio-Cortez and Sanders rally in Durham, New Hampshire on Feb. 10. Photo: Joseph Prezioso/AFP via Getty Images

Rep. Alexandria Ocasio-Cortez (D-N.Y.) conceded Thursday that Sen. Bernie Sanders' signature Medicare for All proposal would face congressional roadblocks if he was elected president, telling HuffPost: “A president can’t wave a magic wand and pass any legislation they want."

Why it matters: Ocasio-Cortez is a vocal proponent of Medicare for All and one of Sanders' highest-profile surrogates. She told HuffPost: "The worst-case scenario? We compromise deeply and we end up getting a public option. Is that a nightmare? I don’t think so."

Go deeperArrowFeb 13, 2020 - Health