How to Answer Describe Role Employer Questions (Complete Guide)

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Original Question

Describe the role of Employer-Sponsored Health Insurance (ESHI). Include a discussion on the impact of ESHI on the uninsured population in the U.S. and any relevant statistics. Discuss any barriers to ESHI, including access to health services. Employer Sponsored Health Insurance (ESHI) is a health insurance plan that employers provide to their employees. It is currently the main avenue where nonelderly U.S. residents get their health coverage from. The practice of employers providing health insurance to their employees first started in mid-20th century to attract and retain employers. According to the IRS about 98% of ESHI plans pay at least 60% of covered healthcare costs. (MoehrleThomas, 2015). Employers negotiate rates with insurance providers and there are some benefits that come with ESHI. Employee Sponsored Health Insurance tends to have easy enrollment, guaranteed coverage and is lower cost to both the employer and employee. ESHI does have a significant impact on the uninsured population in the U.S. because it currently provides health coverage to a large portion of the United States population. In 2023 ESHI covered 53.7 % of the U.S. population. (US Census Bureau, 2024). Uninsured individuals usually have limited to no access to healthcare due to coverages being too high and them simply no having access to coverage through a job. While ESHI has managed to decrease the population of uninsured individuals, during economic turn downs like the COVID pandemic, most companies laid off their workers and this resulted in a higher uninsured population. The unemployment rate rose from 4% to 14.7% (Society for Surgery of the Alimentary Tract, 2020. This meant that a sizable number of individuals and their families lost ESHI. There are several barriers to ESHI. ESHI can be expensive for both employees and employers. Some employers cannot offer insurance for their workers, and some employees simply cannot afford to pay for the premiums. There is also the problem of eligibility. Some workers that are considered part time, and temporary are unlikely to be offered health insurance. Another barrier is due to lack of flexibility employers tend to choose group insurances and employees do not have a say in it. This results in ESHI might have higher deductibles and a higher copay and so this limits their access to healthcare. There are some employees that would have to prioritize what they would rather be seen for versus addressing all concerns. After Affordable Care Act was implemented, the roles of ESHI shifted due to employers still maintaining their EHSI offerings, but they focused more on cost management. This meant that employers were attempting to manage costs due to the “pay or pay” mandate that required employers to provide coverage or face penalties. Employers found ways to better manage healthcare costs within their plans by offering a wider range of plan options, high deductibles, tiered networks, and health savings accounts. (Employer-Sponsored Health Insurance and Health Reform, n.d.) Employers also sought to invest in employee education initiatives to help them better understand the various insurance options that were offered, along with cost saving strategies that were both beneficial to the employers and employees. Employers also had to comply with the Affordable Care Act aforementioned “pay or play act”. They also expanded access to telehealth services to help employees receive care remotely, potentially reducing barriers that hail from time and location constraints.

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