My health insurance is provided by my employer.  Although I may sometimes complain about co-pays, rising deductibles, outrageous prescription drug costs and unforeseen out-of-pocket medical expenses, I realize just how fortunate I am.

If, however, you’re an employee of a small business, or worse, you’ve lost a job as a result of the economic distress caused by the Covid-19 pandemic, chances are you’re out of luck.  If it were not for the Affordable Care Act (ACA), you (and your dependents) would be completely on your own. Those among us who can least afford it would have to pay the outrageous cost of private insurance or, as is often the case, go without it.

According to the Congressional Budget Office (CBO), the number of uninsured Americans in 2020 approached 31 million and as the Covid pandemic forced shutdowns of large segments of the global economy, these numbers have only increased. 

I have a family member battling cancer.  The cost of her care and treatment is astronomical – but thankfully, she is covered for most of these costs by her husband’s employer-provided insurance. But, if she and her husband were suddenly to find themselves unemployed, would I be watching her die without her desperately needed treatment? Why is her life – or anyone’s for that matter — tied to the serendipity of employment? 

In the America of the early 1900s, medical science and technology were fairly primitive, health care services and hospitalizations were unregulated, and medical insurance was virtually nonexistent.  Physicians practiced and treated patients in their homes and most Americans paid their modest medical fees out-of-pocket, often being far more concerned about the wages they would lose if illness kept them out of work than about the cost of their medical care.

During the 1920s, the cost of medical care in the US rose dramatically due to growing demand and higher quality standards for physicians and hospitals. Over the following decades, advances in medical technology and the growing acceptance of medicine as a science led to the emergence of hospitals as credible centers for treatment. They were now modern scientific institutions that valued antiseptics and cleanliness and used medications for the relief of pain. Citizens who could afford to, began to purchased their own private health insurance.  

During World War II, inflation was on the rise. The 1942 Stabilization Act, which was meant to combat inflation during wartime, limited employers’ ability to raise wages. This meant employers could not offer higher salaries to attract employees.  Employers began to offer pre-tax health insurance coverage as “fringe” benefits instead.  Suddenly, employers were in the business of providing health insurance and the modern era of employer-sponsored health insurance began. To this day, employer-based health benefits are the most common form of health coverage.  

In 2017 approximately 167 million Americans under 65 relied on employer-based healthcare. In 2021, through no fault of their own, too many of our fellow citizens are unemployed and don’t have employer-sponsored health insurance. What are they supposed to do when they get sick?  

We can and must provide affordable health care to all New Jersey residents.  When I get to Congress I will make that one of my highest priorities.