The effects of the affordable care act on workers' health insurance coverage

Employer-sponsored health insurance is the cornerstone of the U.S. health insurance system. David Blumenthal, among others, has described this system as an "accident of history," and he quotes Uwe Reinhardt, a leading authority on health care economics, as asserting that "If we had to do it over again, no policy analyst would recommend this model."1 Nonetheless, the Patient Protection and Affordable Care Act of 2010 (the ACA) builds on, rather than eliminates, employer-sponsored insurance. However, because the ACA makes substantial changes to the employer-based system, some wonder whether the employers' role in providing insurance will diminish or disappear over time.