By NextBestFitPhase 4: Wave 4: everyone · Step 4.2
End employer-sponsored insurance for covered services
Year 4 · Employers; DOL; OPM (FEHB); state & local governmentsDiscuss this step
Job-based coverage for UHP services ends for about 179 million people. Employer premium payments of $1.05T (private, federal, state & local) stop; the employer tax ($873.4B) is at its full rate. Worker premium contributions ($382.1B) end.
Legal vehicle
Universal Health Act, Titles VIII & IX.
Who does it
Employers; DOL; OPM (FEHB); state & local governments
When
Year 4
In this step
Tasks
6 tasks
Costs & calculations
11 cost items, each with its calculation
Trade-offs
3 pros · 3 cons · 3 trade-offs
Risks
1 risks with mitigations
What changes in the system
5 existing laws, programs, or institutions changed
Other countries
3 comparisons
Cost items
- Employer share of job-based insurance premiums$0.0B
- Worker share of job-based insurance premiums$0.0B
- Federal employer premiums (FEHB)$0.0B
- Retiree drug subsidy$0.0B
- State & local employer premiums$0.0B
- Jobs: Employer HR benefits administration (health portion)−$1.8B
- Employer: Small business, no coverage$-22,500
- Employer: Small business, offers coverage$112,500
- Employer: Large employer$67,768,750
- Employer: High-wage tech firm$-2,381,250
- Employer: State government$1,275,018,750
Steps that depend on this one
None.
Sources: KFF (2025)