By tying healthcare to employment, the private health-insurance sector is exploiting working-class Americans by providing unequal access to healthcare and further encouraging workers to lock themselves into unfulfilling jobs that may subject them to unsustainable working conditions.

Healthcare in the United States is largely provided through private entities like Kaiser Permanente. In 2022, the California Healthcare Foundation (CHCF), found that Kaiser provided 56 percent of all enrollments in the “individual and small group markets.” CHCF is a nonprofit centered around securing health insurance for “Californians with low incomes and for communities who have traditionally faced the greatest barriers to care.” 

Coverage plans are often tiered and paid for by public, private, and out-of-pocket payments or any combination of the three. In doing research for this article, I found the process of determining my eligibility for public and private programs convoluted and discouraging. 

The higher the tier of coverage, the higher the premium but the lower the deductible. Kaiser’s “Platinum” tier offers a 530 dollar premium with no annual deductible and the lowest copayments. The “Minimum Coverage HMO,” Kaiser’s lowest tier, comes with a 250 dollar premium and a 9,200 dollar annual deductible that must be spent on health services before their insurance covers the cost procedures and prescriptions. 

Customers are being punished by having to pay more for healthcare before their insurance kicks in on top of paying an already demanding monthly payment for their coverage plan.

When determining if I qualify for financial help on Kaiser’s official website, I had to provide my estimated household income. Despite the three of us making under 65,000 dollars annually as individuals, I was disqualified for aid because we made too much money as a unit. If I am applying for individual coverage, why does my household income matter? Why is my family expected to help me with medical expenses when rent and groceries dominate our monthly expenses?

In 2023, the U.S. Census Bureau found that 92 percent of Americans have health insurance, with 65.4 percent of enrollments coming from private entities and 36.3 percent coming from public plans. 

According to the same study, 53.7 percent of the insured population are covered through their employer with Medicaid and Medicare each covering 18.9 percent. Out-of-pocket coverage makes up 10.2 percent.

If these statistics and processes sound confusing, that is the point. The healthcare system is not only broken, but feels intentionally obfuscated by a network of private industries, brokers and federal laws that contradict that of the state.

For example, the federal government mandates that an employer with 50 or more full-time employees must offer at least minimal benefits packages, but according to California law, there is no such obligation. 

The Social Security Administration details that “People age 65 or older, who are citizens or permanent residents of the United States…” are the most eligible for Medicare, and even if they do meet the base requirements for Medicare, the specifics and quality of care are then separated into parts “A” and “B” that have their own set of requirements.

According to Health for California, a health insurance enrollment center, “To qualify for free Medi-Cal coverage, your income must align with 138% of the poverty level,” and or receive aid through other federal programs like refugee assistance. For reference, a family of 3 must make below 35,362 dollars annually to qualify for free coverage.

For full-time students that work part-time, they may not qualify for coverage through their employer because they don’t meet the legal hourly requirement, and if they are 26 or older they are no longer eligible to be covered by their parents’ plans as a result of the Affordable Care Act (ACA).

The ACA also imposes tax penalties against those who are uninsured, further punishing people who already can’t secure sufficient access to healthcare. 

Even if a person is employed, they could be laid off at any time for any reason. According to the state’s Employment Development Department (EDD), as of June 2025, San Joaquin county has an unemployment rate of 7.2 percent which is 3.2 points higher than the national average of 4.3 percent as of September 2025 as calculated by the U.S. Bureau of Labor Statistics. 

Because public health insurance programs are so convoluted, the simplest method of securing coverage is through an employer. The employee has no say over what provider the company may partner with or what tier of coverage they provide, so they either hop from job to job in an unstable job market to secure adequate health benefits or lock themselves into a position where they stay on to keep their current healthcare plan for themselves or their dependents. 

The point is, mixed profit or entirely for-profit health insurance companies have a vice-grip on the working class in America that is impeding class-mobility and siphoning exponentially growing profit from workers to the top providers, like Kaiser CEO Gregory Adams who, according to the Economic Research Institute (ERI), made over 12 million dollars in 2023 despite Kaiser being a non-profit organization.