Inching towards universal health coverage
Health insurance can’t be universal unless it is separated from both employment and marriage / relationship status. However, most health care reform proposals center on expanding job-based insurance. Most employers use marital status (or sometimes, relationship status) to define the family eligible for coverage. Small employers may have to follow the family definitions set out by whatever insurance plans they can afford. Narrow definitions of family inevitably discriminate against a wide variety of caring relationships. Basing coverage on any relationship inevitably discriminates against singles.
Only a true single-payer system would offer all individuals an equal starting point for levels of care and costs. While we’re waiting for single-payer, advocates can generate dozens of opportunities to increase the number of unmarried people covered by job-based insurance, by applying three simple principles. These principles are guiding AtMP’s work on health care, and I’ll present them in a series of blog posts.
Principle #1: Cover More Relationships
Job-based family insurance should cover an employee plus one non-dependent adult plus tax dependents. Many American workers are primary caretakers for siblings, parents, neighbors or friends. These responsibilities fill the function of family, not only for these workers and the people they care for, but also for the larger society, which is spared from allocating public caretaking resources. Insurance coverage would both validate people’s chosen families and also make these families more effective.
Recent news from Salt Lake City, Utah offers a good example of “plus-one” coverage. Back in 2004, Salt Lake City amended its procurement rules to provide preference for companies with non-discrimination policies that include protections for GLBT employees. It would be great if SLC would now strengthen this rule (generically called an Equal Benefits Ordinance) to requiring that any business with a public contract cover adult-designees to the same extent as spouses.
