As part of “The Promise of Health Reform and a Public Option in a Biden Administration,” a virtual conference organized by Penn’s Leonard Davis Institute of Health Economics and United States of Care, Professor of Law Allison Hoffman recently presented “A Public Option for Employer Health Plans.” The paper was co-authored by Howell E. Jackson of Harvard Law and Amy Monahan of University of Minnesota Law and proposes a middle ground between “Medicare for all” and an individual public option for health care plans in the United States: an employer public option.
The proposed solution would allow employers to select a public plan for their employees when it makes most sense for the employers and the workers – a path that would provide “a gradual way to loosen reliance” on the current employer-based private health coverage, which is “in decline” and also “increasingly leaves workers vulnerable” and employers burdened by increasing health care costs. Under this solution, employers would be able to select a public plan “based on Medicare and altered to meet the needs of working populations” in the place of a private plan.
The paper explores the policy, regulatory, fiscal, and business arguments in favor of this form of the public option. The authors maintain that this form of public option is “less disruptive than Medicare for all but more impactful than an individual public option.” They show that it could create a better option for many employees, while freeing employers from the regulatory and financial burdens of being a health insurer, especially as they struggle to manage escalating healthcare prices.
Ultimately, the authors envision that the employer public option would result in a system more “akin to Medicare-for-Many in a less politically, legally, and fiscally fraught way.”
“Because employer take up would be gradual and voluntary,” the authors write, “our plan has lower fiscal costs and should face less resistance from employees and vested interests than Medicare for All.”
Hoffman also wrote about the proposal of a public option for employers at Harvard Law’s Bill of Health.
Hoffman is an expert on health care law and policy and 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.
She co-edited the Oxford Handbook of U.S. Health Law with I. Glenn Cohen and William M. Sage, which offers the most comprehensive review of U.S. health law in the post-ACA era. Hoffman was awarded the Robert A. Gorman Award for Excellence in Teaching in 2018-19. She is currently working on the 3rd Edition of The Politics of Medicare with her mentor Ted Marmor.
You can listen to a podcast created from the event at Tradeoffs: 3 Employers, 2 Wonks and 1 Health Insurance Mess and also watch a video of Hoffman’s presentation: