Why Your Health Insurance Doesn't Cover That

The US employer-based health insurance system originated from a 1943 wartime workaround when employers offered health benefits to attract workers under wage controls, later codified by a 1954 tax exclusion. This accidental system has a fundamental flaw: it ties healthcare access to employment, meaning people lose coverage when they lose jobs, get sick, or start businesses. The system persists because its largest beneficiaries—higher-income workers and employers—are those who influence policy, with the tax exclusion costing roughly $350 billion annually in foregone revenue.