Is the employment-based health insurance system Unconstitutional?

By Ian Wasser

In the United States, health insurance benefits are often included in employment compensation packages.  Thus, to be insured, one must typically have a job.  But what happens when there is racial inequality in the job market? Does this translate into minority groups essentially being denied health insurance coverage and therefore having an unnecessarily higher mortality rate?

The answer might be yes.  According the the Bureau of Labor Statistics, unemployment rates differ between majority and minority groups.  For instance, in 2003, the unemployment rate for white males was 5.0% while the unemployment rate for african-american males was 10.3%.  If health insurance is exclusively linked to employment, then clearly twice as many african-american males are being denied health insurance coverage when compared to white males.

As applied, the health insurance regime in the United States clearly violates the equal protection clause of the Fourteenth Amendment.  Specifically, the practice of linking health insurance to employment places an often already disadvantaged class of people into a position of further disadvantage.  This translates into poorer health and higher mortality.  Can it then be said that employment-linked health insurance, on the whole, is Unconstitutional?