Health Care Reform: Undoing Obama's Health Law Could Have Messy Ripple Effects

#1:

Insurance is typically, and will continue to be, tied to employment.  And in these times of economic uncertainty and chaos, one of the many problems with designing programs to use the employment system to expand health insurance coverage is that employment is not static. When insurance is tied to employment, turnover in employment results in turnover in insurance. However, recent evidence suggests that continuity in coverage and care are just as important as having coverage is in improving access to healthcare.  

Linking coverage to the workplace will not promote continuity in coverage for some population groups. Job losses are more common among younger, lower-income, and less educated workers. In addition, most new jobs are short-term; about 20% last less than three months, and about 50% last less than a year. This turnover raises the question of when and for whom an employer insurance buy-in is consistent with the policy goal of continuity. Employment turnover also raises states’ cost of administering employer coverage buy-in programs.

Then there's how employer-provided insurance drives down salaries:

ACA will create perverse incentives with respect to a number of important decisions affecting low- and moderate-income Americans, including: the ACA will deter low- and moderate-income taxpayers from accepting jobs with employers that offer “affordable” health insurance; the ACA will discourage many low- and moderate-income taxpayers from attempting to increase their household incomes; the ACA will penalize many low- and moderate-income taxpayers who choose to marry and will incentivize many low- and moderate-income taxpayers to divorce; the ACA will dissuade employers from hiring low- and moderate-income taxpayers and will encourage employers to reduce the salaries paid to some low- and moderate-income employees; the ACA will prompt employers to shift some low- and moderate-income employees from full-time positions to part-time positions; the ACA will tempt employers to implement a number of other costly strategies for circumventing the ACA’s employer mandates and penalties; the ACA will induce employers to stop offering “affordable” health insurance to at least some low- and moderate-income employees, and – if this occurs to a significant enough degree – the budgetary cost of the ACA may greatly exceed the official projections issued by the Congressional Budget Office.

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Read the Article at HuffingtonPost