Over the past 25 years, the cost of family employer-based health plans has surged from $65,100 to nearly $24,000, placing a significant financial burden on workers. The share of premiums and out-of-pocket costs for employees has also escalated dramatically. In 2007, 60% of individuals with employer-based coverage had deductibles under $500; today, that figure has flipped, with 60% facing deductibles exceeding $1,000. This shift means that many low-wage workers must pay more than their available bank balance before their insurance coverage begins.

During a recent government meeting, experts highlighted the unsustainable nature of rising healthcare costs for both workers and employers. They urged Congress to take decisive action to enhance healthcare affordability. Proposed measures include addressing market failures that contribute to escalating costs, ensuring price transparency, and implementing site-neutral payments. Additionally, there is a call to expand prescription drug cost containment policies from the Inflation Reduction Act into the commercial market, which would provide broader discounts on medications.

The discussion also emphasized the importance of extending enhanced tax credits to prevent significant premium increases if they expire next year, as well as instituting caps on out-of-pocket costs for both prescription drugs and general healthcare expenses.

Paul Fronston, director of health benefits research at the Employee Benefit Research Institute, noted the historical context of employer commitment to worker health, tracing it back to the late 1800s. He explained that during World War II, the provision of health insurance became a strategic tool for employers to attract and retain employees, as contributions to insurance were exempt from wage controls.

The meeting underscored the urgent need for reforms to improve access to affordable healthcare coverage for workers and their families, building on the foundation established by the Employee Retirement Income Security Act (ERISA).