As midterm season gears up, few issues will attract more attention than healthcare, especially as it relates to affordability. Politicians on both sides are floating reforms and big ideas: including public options, new mandates, and changes to how coverage is taxed. Amid these proposals, an obvious but winning narrative often goes ignored: protecting and strengthening the employer-provided coverage (EPC) that underpins America’s healthcare system.
More than 180 million Americans and their families receive healthcare through their workplace, and they overwhelmingly want to keep it that way. A recent national survey found that roughly 90% of workers support their EPC, with even more (96%) citing it as crucial to their family’s financial security. Likewise, the vast majority would much rather access their coverage through their employer, not the federal or state government.
For businesses, too, the return on investment for employer-provided coverage remains high. The logic is straightforward: healthier employees miss fewer workdays, maintaining operational continuity, and access to preventive care keeps workers performing at full capacity. Through employer-sponsored plans, millions of Americans receive no-cost services including cancer screenings, mental health resources, and nutrition counseling. Catching health problems early means fewer emergency interventions, lower claims costs, and less disruption to the workforce. In other words, what’s good for employees’ health is also good for the bottom line.
In addition, employers understand that quality coverage is a powerful tool for recruiting and retaining talent. In a competitive labor market, a company that offers health coverage with comprehensive benefits has a significant edge, attracting employees and reducing the recruitment and training expenses that come with high turnover. When considering a compensation package, prospective employees often see health coverage as their top benefit – more so than retirement plans, paid leave, or any other perk. In fact, 85% of workers claim they’d consider leaving a job if EPC were not offered.
Employer-provided coverage also functions as critical infrastructure for the broader U.S. economy. Research from the National Bureau of Economic Research found that employer-sponsored coverage delivers $800 billion in personal value to American families and saves consumers $100 billion in health care costs each year. That means more capacity for consumer spending and greater margins for employers to grow and reinvest in their workforce. It’s a win-win-win situation: when workers are healthy and labor force participation rate is high, employers benefit financially, and the entire economy runs better.
Given all of this, the most consequential mistakes Congress could make right now is undermine the policy framework that makes the system function. The current tax exclusion, which allows employees to exclude premiums from taxable income while permitting employers to deduct those costs, is what makes employer-provided coverage affordable. Eliminating or limiting that exclusion would effectively raise taxes on working families at the worst possible time, when affordability concerns are high. Similarly, a government‑run public option would undermine the existing system by discouraging employer participation, eroding risk pools, and reducing the flexibility and competition that drive efficiency.
More than 180 million Americans and their families receive healthcare through their workplace, and they overwhelmingly want to keep it that way. A recent national survey found that roughly 90% of workers support their EPC, with even more (96%) citing it as crucial to their family’s financial security. Likewise, the vast majority would much rather access their coverage through their employer, not the federal or state government.
For businesses, too, the return on investment for employer-provided coverage remains high. The logic is straightforward: healthier employees miss fewer workdays, maintaining operational continuity, and access to preventive care keeps workers performing at full capacity. Through employer-sponsored plans, millions of Americans receive no-cost services including cancer screenings, mental health resources, and nutrition counseling. Catching health problems early means fewer emergency interventions, lower claims costs, and less disruption to the workforce. In other words, what’s good for employees’ health is also good for the bottom line.
In addition, employers understand that quality coverage is a powerful tool for recruiting and retaining talent. In a competitive labor market, a company that offers health coverage with comprehensive benefits has a significant edge, attracting employees and reducing the recruitment and training expenses that come with high turnover. When considering a compensation package, prospective employees often see health coverage as their top benefit – more so than retirement plans, paid leave, or any other perk. In fact, 85% of workers claim they’d consider leaving a job if EPC were not offered.
Employer-provided coverage also functions as critical infrastructure for the broader U.S. economy. Research from the National Bureau of Economic Research found that employer-sponsored coverage delivers $800 billion in personal value to American families and saves consumers $100 billion in health care costs each year. That means more capacity for consumer spending and greater margins for employers to grow and reinvest in their workforce. It’s a win-win-win situation: when workers are healthy and labor force participation rate is high, employers benefit financially, and the entire economy runs better.
Given all of this, the most consequential mistakes Congress could make right now is undermine the policy framework that makes the system function. The current tax exclusion, which allows employees to exclude premiums from taxable income while permitting employers to deduct those costs, is what makes employer-provided coverage affordable. Eliminating or limiting that exclusion would effectively raise taxes on working families at the worst possible time, when affordability concerns are high. Similarly, a government‑run public option would undermine the existing system by discouraging employer participation, eroding risk pools, and reducing the flexibility and competition that drive efficiency.
Too often, the temptation in Washington is to treat every policy issue as an invitation for wholesale reform. But when the vast majority of Americans favor their employer-provided coverage, Congress should resist the pressure to jeopardize a system that is working. The goal should be to make EPC work better to protect affordability and not replace it with an unsustainable model.
Terrence Upchurch is a Democratic state representative in Ohio and the President of the Ohio Legislative Black Caucus.
