Apr 15, 2019

How Medicare for All could impact employers

Sen. Bernie Sanders introduces his Medicare for All bill of 2019. (Photo: Tom Williams/CQ Roll Call)

Medicare for All could end up costing employers less than the current employer-sponsored health insurance system does, depending on how it's structured.

Yes, but: That certainly doesn't mean employers are on board, partially because other concerns — like access to health care and the competitive advantage that generous benefits can create — may outweigh cost and convenience.

The big picture: Employer-sponsored insurance is hugely expensive, a pain to administer, yet an embedded part of the American system.

  • "Employers are in some ways a natural constituency for Medicare-for-all. But, the business community is generally not ideological inclined to support a government takeover of a whole sector of the economy like health insurance," said the Kaiser Family Foundation's Larry Levitt.

What they're saying: Employers provide health insurance "because it’s a benefit that attracts employees. It’s a benefit they like to provide, even if it’s expensive," said Neil Bradley of the U.S. Chamber of Commerce. "They’ve chosen to do it, because they think it makes good business sense.”

  • He said that things like choice and access to medical care — which he said would be hindered under Medicare for All — are more important to employers: "Cheaper is not necessarily better."

The other side: "I’ve talked to a Fortune 500 CEO who says he would love [Medicare for All], and who told me he knows plenty of others who feel that way," said House Budget Committee Chairman John Yarmuth.

  • "I think it’s that his experience in providing health care benefits, and watching his franchisees struggle with it, convinced him that standardized coverage is more efficient and cost effective," Yarmuth added.

By the numbers: Health benefits made up 8.3% of employee compensation in 2019, according to the Bureau of Labor Statistics. This translates into 12% of payroll, or of wages and salaries, Levitt said.

  • Sen. Bernie Sanders' Medicare for All financing "options" that he released last week included a 7.5% "income-based premium" paid by employers, with the first $2 million in payroll exempted.
  • But most economists assume that workers end up shouldering the cost of their employer insurance today through reduced wages, and that would continue if premiums were replaced with a tax to fund Medicare for All.
  • Business owners would likely bear the brunt of some of the other taxes on the wealthy proposed in Sanders' financing options, and "business groups ultimately act in the interest of business owners," Brookings' Matthew Fiedler said.

The bottom line: How employers feel about Medicare for All — or more specifically, Medicare payment rates for everyone — could change over time, as the cost of private employer-sponsored insurance skyrockets, said former Trump administration health official John Bardis.

  • The private sector is currently paying much higher rates than Medicare for the same services, "and that in and of itself may be a starting point in the discussion around the cost of health care in the United States," Bardis said.

Go deeper: Employers' health care crisis will only get worse

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Coronavirus dashboard

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  1. Global: Total confirmed cases as of 10 p.m. ET: 1,014,673 — Total deaths: 52,973 — Total recoveries: 210,335Map.
  2. U.S.: Total confirmed cases as of 10 p.m. ET: 244,678 — Total deaths: 5,911 — Total recoveries: 9,058Map.
  3. 2020 updates: The Democratic National Committee said its July convention will be postponed until August because of the coronavirus. A federal judge declined to delay Wisconsin's April 7 primary election.
  4. Jobs latest: Coronavirus unemployment numbers are like a natural disaster hitting every state.
  5. Public health latest: Anthony Fauci called for all states across the U.S. to issue stay-at-home orders. The FDA will allow blood donations from gay men after 3-month waiting period, citing "urgent need."
  6. Business latest: Treasury Secretary Steven Mnuchin said oil companies are eligible for aid from new lending programs the Federal Reserve is setting up, but not direct loans from his department.
  7. U.S.S. Theodore Roosevelt: Navy removes captain of aircraft carrier who sounded alarm about coronavirus.
  8. 1 future thing: In developing countries, consequences of COVID-19 could be deeper and far more difficult to recover from.
  9. What should I do? Answers about the virus from Axios expertsWhat to know about social distancingQ&A: Minimizing your coronavirus risk.
  10. Other resources: CDC on how to avoid the virus, what to do if you get it.

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