Problems with Employer-Provided Health Insurance — The Employee Retirement Income Security Act and Health Care Reform

Health care reform is in the wind. As the nation prepares for a new presidential term, a more equitable and cost-effective health care system is beginning to sound inevitable.1 But the shape of that system remains a matter of debate. Employer-provided health insurance is the cornerstone of several national proposals for reform.2 3 4 5 6 The Bush administration\u27s preference for tax credits rested on the assumption that most employers would continue to provide health insurance to their employees. President-elect Bill Clinton\u27s proposal relies on insurance reform to enable small businesses to buy affordable private health insurance. Lawmakers in several states, such as Massachusetts, frustrated by federal inaction, have enacted or proposed new health care legislation to expand health coverage to all employed people.7 These efforts assume that equitable, universal access to health care can be achieved by expanding employer-provided health insurance