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Public, Private, & Premiums: How Government & Business Influence Health Insurance

APEF: Solving the Financial Illiteracy Crisis

Soft skills refer to a set of personal attributes, behaviors, and social attitudes that enable individuals to interact effectively with others in a workplace or social environment. These skills are essential for building healthy relationships, communicating effectively, solving problems, and collaborating with others.

an expense that a you can subtract from adjusted gross income, reducing the amount of taxes owed

tax that is withheld from an employee's paycheck and paid by the employer to the government

an amount of money set aside as a financial safety net for unexpected expenses, usually recommended to be approximately 3-6 months worth of expenses

Health insurance is critical in providing access to essential medical services, and private businesses and the government greatly influence it. Today, we’ll take a closer look at the absolutely thrilling roles both play in health insurance (did the sarcasm come through there?) and how it impacts you personally (AKA, why we have to talk about it). 


The Role of Businesses in Healthcare


Businesses play a big role in providing health insurance to their employees through employer-sponsored plans. These plans offer comprehensive protection at a lower cost than individual policies; typically, employers negotiate group rates with insurance providers, and employees cover part of the premium (the monthly fee). Employer-sponsored policies frequently cover medical visits, hospital stays, and prescription drug coverage that individual plans cannot always provide. It’s always good to inquire about health benefits when applying to jobs- a good employer health plan can save you thousands in medical costs per year. Some employers even cover the entire premium as an added benefit!


In other health-related offerings, some businesses promote employee well-being by providing wellness programs like gym memberships and health screenings or offering incentives for healthy behaviors. Some employers even provide flexible spending accounts so employees can set aside pre-tax funds for medical expenses.  Businesses also play a pivotal role in developing new healthcare technology through research and investments, including virtual doctor visits (telemedicine) and apps to track health metrics- making access to care more accessible and more convenient. 


The Role of Government in Healthcare (keep reading- you’re halfway there!)


Government policies play a big part in health insurance as well. Programs like Medicare provide coverage to senior adults (aged 65 or over) as well as young individuals with disabilities. At the same time, Medicaid covers low-income individuals and families, while the Children's Health Insurance Program (CHIP) helps families who earn too much to qualify for either of the above. The Affordable Care Act (which you may have heard referred to as the ACA or Obamacare) was signed into law in 2010 and has had an enormous effect on health insurance. The goal was to enhance access and increase insurance coverage among citizens. One of the main features of the Affordable Care Act (ACA) is its Health Insurance Marketplace, where individuals and families can shop and compare insurance plans. This marketplace offers various plans with differing costs and coverage options to make it easier for consumers to find one that fits their needs and budget. The ACA also introduced subsidies (financial assistance) for individuals and families with low and moderate incomes and expanded Medicaid in many states. 


For businesses, the ACA established employer mandates for certain companies to offer health insurance to their full-time employees. Companies with 50 or more full-time employees must provide insurance or face penalties; this has increased access to employer-sponsored insurance and encouraged businesses to offer health benefits- a big win for employees.


Businesses and the government both play vital roles in shaping health insurance. Employer-sponsored plans provide employees access to group plans and wellness programs, while government programs cover specific groups like seniors or low-income families. Regulation and oversight by the government can also help ensure fair policies. By understanding the involvement of businesses and the government in health insurance, you can better navigate the system and make informed decisions about your healthcare. It may not be the most exciting thing you’ll read about today, but knowing how health insurance works can help you plan for your future health and well-being!

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