One of President Obama’s key advisers in drafting the healthcare legislation that is now law says Obamacare will eventually spell the end of employer-based health plans.
Experts from both sides of the aisle aren’t upset by the idea of removing employers from the health care equation, however both sides are also skeptical that Obamacare will have the effect Emanuel predicts.
Emanuel is quoted in The New York Times saying that a few blue chip companies will be the tip of the movement but that many other firms will quickly follow suit. In an early March piece for The New Republic, Emanuel explained how the change will happen.
“For the next few years insurance companies will both continue to provide services to employers and, increasingly, compete against each other in the health insurance exchanges. In that role they will put together networks of physicians and hospitals and other services and set a premium. But because of health care reform, new actors will force insurance companies to evolve or become extinct,” wrote Emanuel.
“The accountable care organizations (ACOs) and hospital systems will begin competing directly in the exchanges and for exclusive contracts with employers. These new organizations are delivery systems with networks of physicians and hospitals that provide comprehensive care.” he wrote.
Before experts even consider whether this would be a good idea, they’re largely in agreement that Emanuel is wildly optimistic about how this will play out.
“What’s he sprinkling on his breakfast cereal and where can I get some?” asked David Hogberg, health care policy analyst at the National Center for Public Policy Research.
“It basically hinges on two things. Number one, the Obamacare exchanges becoming very popular and very effective. At this point, I don’t see any of that in the future. The second is the Cadillac tax on high-end employer-based health plans coming into effect in 2018. That itself is a pretty thin reed to hang this on. That’s going to effect big employers and a lot of union plans,” said Hogberg.
“I suppose there’s no such thing as an unstoppable political coalition but big employers and unions together, that would come about as close as you can get,” he said.
Emanuel also argues that employers are looking to get out of their health care role anyway, and this would be the perfect avenue. That also has Hogberg scratching his head.
“Why didn’t they do that before Obamacare. Before Obamacare they didn’t have to pay a $2,000 fine. What keeps companies in employer-based plans is that employees demand it. It’s part of the compensation package and the reason employees demand it is that there’s this huge tax break for it. As long as it’s tax-free and employees demand it, it doesn’t matter so much what companies want to do,” said Hogberg.
“I really don’t see much in Dr. Emanuel’s argument that is at all convincing,” said Hogberg.
