End employer-sponsored insurance for covered services

Year 4 · Employers; DOL; OPM (FEHB); state & local governmentsDiscuss this step

Every existing law, program, institution, or practice this step changes: what it is today, what happens to it, when, and what that costs or trades off.

What	Today	Change	Trade-off
Federal Employees Health Benefits (FEHB) & Postal Service plan (PSHB) endsYear 4 Federal programs	About 8M federal employees, retirees, and families.	Closes in Year 4; the employer contribution converts to pay or retirement benefits. Federal employer premiums (FEHB) $46.7B → $0.0B Federal employer health payroll tax (new) $0.0B → $30.0B	Federal workers lose a valued benefit choice; the government becomes a regular employer-taxpayer.
State & local employee and retiree health plans endsYear 4 States & localities	Teachers, police, and public workers; large unfunded retiree-health (OPEB) liabilities.	Close; employer pays payroll tax; OPEB liabilities largely extinguished. State & local employer premiums $246.8B → $0.0B State & local employer health payroll tax (new) $0.0B → $100.5B	Big savings for state budgets; public-sector unions lose a core bargained benefit.
Employer health benefits endsYear 4 Private sector	179M people covered through work; employers choose plans and administer enrollment.	End for covered services; payroll tax; maintenance-of-compensation for 3 years.	Ends job lock; employers lose a recruitment tool.
Multiemployer (Taft-Hartley) union health funds endsYear 4 Private sector	Jointly trusteed funds covering millions of union members.	Convert to supplementary benefits or dissolve; assets to members or pensions.	Unions lose an institutional role; members gain portable coverage.
Employer wellness programs and on-site clinics amendedYear 4 Private sector	Tied to health plans (premium discounts for participation).	Premium-based incentives end; on-site clinics may bill UHP as participating providers.	Ends incentive schemes that penalized less healthy workers; employers lose a tool they used to manage costs.