So Why Do Employers Make Our Insurance Choices Again?

As Hobby Lobby arguments continue, Margaux J. Hall takes issue with the status quo:

[F]or decades we have allowed our employers virtually unfettered freedom to make all health coverage decisions – not just those related to contraceptivess – on behalf of employees and, in many instances, their family members. Why? Isn’t it time to rethink how we got to this place and whether we should do something about it?

Americans often fail to notice that a striking imbalance exists in health insurance purchasing: Although health insurance belongs to the employee, the employer gets to decide what that insurance will cover and under what terms. While contraceptives are the current lightning rod for controversy between employers and employees, tensions have emerged over the years around a whole range of health services, including treatments for autism spectrum disorder, in vitro fertilization, and bariatric surgery.

Why does health insurance actually belong to the employee? Because the employee pays for it – directly and indirectly. Though both employees and employers generally co-finance insurance premiums (in 2012, employees reportedly paid an average of 18 percent of individual plan premium costs, and 39 percent of family plan premium costs), employees functionally fund 100 percent of premium payments.