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Health care's sleeping giant: employers

Illustration of a suited figure with crossed arms on top of a field of circles and medical crosses

Illustration: Natalie Peeples/Axios

Rising health care prices and a tight labor market have put employers in a bind, and some are becoming more politically vocal about costs.

Why it matters: The sleeping giant of the health care world appears to be waking up. If anyone has the political heft to push Congress to take on some of the country’s most powerful interest groups, it’s employers.

  • “Employers can't do anything other than be more engaged. They have been just inexplicably disengaged,” said Mark Miller, executive vice president of health care at Arnold Ventures.

State of play: Think tanks across the political spectrum, from the conservative American Action Forum to the progressive Center for American Progress, are ramping up advocacy around employer-sponsored insurance costs.

Between the lines: Employers are targeting hospitals in particular — but hospitals point the finger at drug prices for rising employer-sponsored insurance costs.

  • “We need a much more comprehensive evaluation of what's going on,” said Molly Smith, group vice president of public policy at the American Hospital Association.

The intrigue: Republican House leaders are trying to get members to think more about the employer rather than the individual market, a senior GOP aide told Axios.

  • “Well over half of insured Americans get coverage from their employer. We would like to focus more on finding better solutions and more options for people with employer coverage because that impacts so many more people,” the aide said.

What we’re watching: Sens. Tammy Baldwin (D-Wisc.) and Mike Braun (R-Ind.) introduced a bill last year to crack down on certain anti-competitive hospital practices.

  • The bill hasn’t been introduced in the House or discussed in committee, and Baldwin hasn’t yet committed to reintroducing it next year, a Democratic aide said. However, it has attracted at least some employers’ attention.
  • Elizabeth Mitchell, president and CEO of the Purchaser Business Group on Health, name-dropped the bill at a Bipartisan Policy Center event on employer-sponsored coverage.
  • “We are certainly very interested in taking on consolidation, and we have done it in the past,” she said, pointing to a successful California lawsuit against Sutter Health that was settled in 2019.

Our thought bubble: All of this momentum could run up against the brick wall of the hospital lobby, and nearly every member of Congress represents at least one hospital. Plus, not all employers are on the same side.

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