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Comment by usaar333 | Hacker News Reader

Isn't this what ACA does? Employers just happen to offer health insurance as a benefit, but I'm not sure why it needs to be banned.

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Employers have significant tax advantages when offering health insurance that individuals do not have access to.

Only if you are unemployed. If you are self employed (e.g. a 1099 contractor), you can write off health insurance. (Basically letting you pay with pretax dollars, the same as if you are employed)

One of the largest county government insurances in CA reimburses $28,000 for an endoscopy at an outpatient center. Which should cost around $2000 in a hospital. And in reality, could cost $500.

Not sure why the AHA didn’t fix things like this.

AHA? You mean the ACA? The US pays more for healthcare for a whole host of reasons split between different categories. The ACA only took on a very small aspect. The idea that getting close to 100% coverage means incentives like jacking up the prices because nobody covers the other guy's ER bill would get much smaller. I imagine the idea was changing other things made more sense to them after most everyone was covered.

https://en.wikipedia.org/wiki/Health_care_prices_in_the_Unit...

ACA plans can be subsidized, but as I understand it, if your employer offers a qualifying plan, then you are not eligible for the subsidy if you buy one from the marketplace instead.

Full-time employers don't just "happen" to offer health care. It's a requirement of the ACA. That codifies a longstanding set of rules that make health care cheaper when offered by an employer, including tax breaks. The ACA does encourage state "exchanges" at rates comparable to the ones that employers provide, there's still a lot of focus on employer-provided health care.

This is the result of a longstanding bargain between unions and employers to provide some compensation as health care rather than salary, which was win-win for both sides until health care costs soared. Now there's no way to break that link without throwing off those negotiations.

The ACA wasn't actually a huge change, except in the sense that any change at all was nearly impossible given the stability of that equilibrium. It's widely agreed that there are many better ways to do it -- all of them dispensing with the link between employers and health care -- but there's no way to get to wide agreement on any one plan.

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