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The Future of America’s Health Insurance

December 08, 2022

“[I]t is an ideal time to begin to invest in policies that can foster a more secure, less complicated, and more equitable post-pandemic horizon of health insurance,” writes Prof. Allison K. Hoffman.

Hoffman’s article is featured in Advances in Research, the University of Pennsylvania Carey Law School’s annual premier publication that highlights outstanding faculty research and scholarship. 

In an article published in the DePaul Law Review, Allison K. Hoffman, Deputy Dean and Professor of Law, describes problems that arise with a U.S. health insurance system overwhelmingly comprised of job-based coverage. In “How A Pandemic Plus Recession Foretell the Post-Job-Based Horizon of Health Insurance, Hoffman predicts that recent events — notably the COVID-19 pandemic — could herald in significant shifts in the way the U.S. organizes and regulates health insurance.

Hoffman is an expert on health care law and policy, examines some of the most important legal and social issues of our time, including health insurance regulation, the Affordable Care Act, Medicare and retiree healthcare expenses, and long-term care.

From Advances in Research:

About half of all Americans are covered by employer-sponsored health insurance (ESI), which has been the dominant source of U.S. health care coverage since the twentieth century.

Even prior to the COVID-19 pandemic, job-based health insurance accessibility and affordability were declining. Not only were fewer employers offering health insurance to their employees, but among those that did, the cost to both employers and employees continued to rise.

First, the number of people working in non-traditional arrangements, such as 1099 or “gig” work, has increased in recent years. Though measuring this data poses challenges, much of this work tends to be structured in ways that does not obligate the employer to provide benefits, such as health benefits.

More critically, many employers, including large corporations, increasingly express frustration at healthcare’s rising costs and their diminishing power to negotiate for prices. Recent data from a survey conducted by a nonprofit organization that represents some of the largest employers and the Kaiser Family Foundation show that employers heavily favor greater healthcare regulation, such as stronger antitrust measures, more price transparency, government price caps, and even perhaps Medicare expansion… .

“Because of the high costs and stakes of COVID-19 care, the federal government and states scrambled to try to keep people insured even as they lost jobs and to provide access to testing and some medical care even if not insured,” Hoffman writes. “The patchwork of policies enacted to pursue these goals perfectly captures the overly complicated healthcare financing system in the United States.”

While several pieces of legislation focused on ensuring that COVID-19 testing and vaccinations remained free regardless of insurance coverage status, COVID-19 treatment was less regulated… .

Explore the rest of this piece on Hoffman’s article and more outstanding faculty research and scholarship in the 2022 edition of Advances in Research.