Just because we have expected employers to select and buy health insurance for the last 50 years, doesn't mean it's a good idea. We need to give all consumers an opportunity to select the plan that's best for them.

First, employer-based insurance cannot cover everyone, all the time. 13% of NM households under 65 are unemployed or early retirees. Only around 80% of employees in businesses that offer medical insurance are actually eligible, mostly because of a waiting period for new hires, or because they work part-time or under contract. And in 57% of NM businesses, spouses and children get no benefits.

Second, employer-based insurance is complicated and expensive to administer. Businesses must pay broker commissions and hire specialized staff, and they risk antagonizing employees over tough benefit decisions. Insurance companies rack up costs by calculating risks and negotiating contracts for thousands of firms, and constantly registering and unregistering participants who change jobs or family situations. Providers often fight with insurers for months because eligibility, rates and copays are not clear.

Third, everyone should be able to make their own individual purchasing decisions. Employers have a conflict of interest when buying health insurance, and cannot satisfy every employee's needs and preferences. Allowing individuals to choose between expensive comprehensive coverage and cheaper products will also encourage people to accept larger patient co-pays and self-regulate their utilization, reducing the cost of insurance overall.

But while this proposal offers an alternative to traditional employer-sponsored group coverage, it recognizes that employers want to keep offering health benefits to attract quality workers, and that businesses play an important role in building a healthy workforce. Employers can still offer medical group coverage to their employees, or they can help employees buy plans from a statewide pool using cafeteria benefit contributions, and they are encouraged to develop workplace wellness programs.