Freelancers and small companies would buy insurance through the same marketplace as everyone else.
The system would finally match the modern labor market.
Addendum II
The Numbers
Several major financial flows already exist inside the American health insurance system.
The tax exclusion for employer-sponsored insurance costs the federal government roughly $296 billion per year.⁵
The top one percent of American households—about 1.6 million tax filers—collectively earn roughly three trillion dollars annually.⁶
That scale matters because even small percentage adjustments to income at the very top generate significant revenue. Every single percentage point of income from the top one percent represents roughly $30 billion.
Because the income base is so large, relatively modest adjustments combined with redirecting the existing employer insurance subsidy could finance expanded marketplace subsidies for millions of Americans.
The proposal therefore relies primarily on reallocating existing spending rather than building entirely new programs.
Bibliography
1. Congressional Budget Office. The Effects of Employer-Sponsored Health Insurance on Wages. Analysis explaining how employer health insurance costs influence wage growth.
2. National Bureau of Economic Research. The Origins of Employer-Based Health Insurance in the United States. Historical study of wartime wage controls and the rise of employer health benefits.
3. Kaiser Family Foundation. Health Insurance Coverage of the Total Population. National data on sources of health insurance coverage in the United States.
4. Centers for Medicare & Medicaid Services. Health Insurance Marketplace Enrollment Data. Federal statistics on ACA marketplace participation.
5. U.S. Department of the Treasury. Tax Expenditures for Health Insurance. Estimates of federal revenue loss from the employer-sponsored insurance tax exclusion.
6. Internal Revenue Service Statistics of Income Division. Individual Income Tax Returns Complete Report. Data on income distribution among top U.S. taxpayers.