Why the Insured Should Support Health Care Reform: Employer Sponsored Health Insurance is an Endangered Species

South Carolina Republican Congressman Joe Wilson's decidedly un-Congressional outburst during President Obama's speech on health care reform was met with swift censure from his colleagues on both sides of the political fence. But while he was publicly called out for his inappropriate and disrespectful behavior toward the President, no one has taken him on for the slanderous allegations that he and other anti-health reformers have propagated for months: allegations that characterize the uninsured as illegal aliens, scofflaws, uneducated and poor. Allegations that have successfully convinced the insured that health care reform is detrimental to their health.

Yet, these charges distort the facts and divert attention from a troubling trend: employer-sponsored insurance is an endangered species and without health care reform, including a public option, many more Americans will join the ranks of the uninsured. Including, potentially, my family.

Of course, we are not illegal immigrants, scofflaws, uneducated or poor. We look like the majority of the uninsured, according to US Census Bureau and the Agency for Health Care Research and Quality. We are American citizens like 85 per cent of the non-insured. One of us has a year-round, full time job, as do 67 per cent of the non-insured. We are college-educated, as are 31 per cent of the non-insured. We are white or "other" as are 30 percent of the non-insured.

What happened to us is what has happened to many of the 14.5 million who are unemployed: we lost our employer-sponsored health insurance when my husband was laid off last year. We did not have the luxury of turning to my employer. Like 17 million other Americans, I am self-employed, a sole proprietor whose health insurance was covered by a spouse's employer.

With signs that the economy is slowly rebounding, many families hope finding a job will restore their health insurance. After all, more than half of all Americans receive health insurance through their employers. But full time employment is no guarantee of health insurance coverage.

The number of private employers offering health insurance has declined steadily this decade. Back in 2000, more than 69 per cent offered their employees health insurance, according to research from the Kaiser Family Foundation and Health Research and Education Trust. By last year, that number dropped to 63 per cent.

The biggest decline came from small businesses, particularly those with fewer than 26 employees. Only 49 per cent of these small businesses offer coverage - down from 57 per cent in 2000. The National Small Business Association corroborates these findings: they found that only 38 percent of their members offer coverage; 14 years ago, 67 percent offered their employees coverage.

The decline in health care coverage by small business employers is particularly troubling since this sector accounted for 94 per cent of all new jobs created in the U.S. in the last two decades. More than 70 million Americans work for a small business today. But small businesses have been crippled by the ever-escalating costs of health insurance and many have been forced to forgo this luxury benefit.

If left unaddressed, this trend of businesses dropping health insurance coverage could add another eight million Americans to the ranks of the uninsured in ten years, bringing the total to 54 million Americans without health insurance, according to estimates by the Congressional Budget Office.

So far our family has not lost its insurance. Unlike others who lost theirs due to unemployment, we were fortunate enough to not only have access to COBRA - a continuation of our health insurance for 18 months - but, also the financial well being to pay the $1500 monthly premiums. Others have not been so fortunate. Some had no access to COBRA when their companies closed up; others had to make the difficult trade off between food and shelter or health insurance because their unemployment payments couldn't cover both.

COBRA ends this month and, with it, our options. While we will save some money, we will pay higher out-of-pocket costs, see a reduction in level of coverage and greater restrictions placed on which doctors, hospitals and procedures we can use. But, at some point, if my husband continues to be unemployed and my business continues with its revenue halved, $1200-a-month health insurance may be an unaffordable luxury for us too. And then we will officially join the ranks of the un-insured. Not as illegal immigrants, scofflaws or the uneducated. But as the working poor, our savings depleted by health insurance premiums.