Protecting Americans' Coverage Together

Protecting Americans’ Coverage Together (PACT) is a campaign aimed at strengthening support for the employer-sponsored insurance (ESI) system – the backbone of our country’s health coverage – while also raising awareness around the serious threats posed by a Medicare buy-in or public option.

PACT brings together a coalition of business voices united in support of strengthening and building upon the current ESI system, rather than resorting to highly disruptive changes that undermine health care coverage for the 180 million Americans who depend on employer-sponsored coverage.



Researchers estimate that under a Medicare buy-in proposal, individuals purchasing coverage on their own could face premium increases up to 10 percent.
Recent Congressional legislation that would establish a Medicare buy-in would increase federal spending by $184 billion over 10 years and only reduce the uninsured rate by .2 percent.
The current Medicare system is designed to support seniors, however, a Medicare buy-in could result in a nationwide loss of over 44,000 physicians – a decrease of 5.4% – by 2050 leading to dramatically increased wait times for patients in need of care.
Imposing a public option could lead to a new 4.8 percent payroll tax on American families over 30 years – far higher than the combined Medicare payroll tax Americans pay today.
Recent estimates suggest that over 30 years, the public option would become the third most expensive government program behind only Medicare and Social Security and could add as much as $700 billion to the federal deficit in its first 10 years.



By shifting employees prematurely into Medicare or forcing them into an untested public health care option, millions of American workers and their families would lose the comprehensive coverage and quality care that they depend on for their health.

Worse, these policies would amount to a downward spiral for the private insurance market, leading to significant disruption across the health system at a time when stability is critically important.

The proposed policy changes are not a silver bullet for companies’ health care cost challenges, and employers would be better off encouraging policymakers to strengthen and enhance the current, reliable system that continues to be the driving force for health care innovation and reliability across the country. 


ESI provides robust, affordable coverage for 180 million families and retirees. The flexibility of ESI allows companies to tailor insurance benefits and coverage to the needs of their specific workforce. This coverage includes broad, robust networks which provide access to major hospitals, academic medical centers and a variety of providers.

Congress recognized the critical role of the ESI program during the current COVID-19 public health crisis by providing funding support and assistance so American workers could maintain their health coverage.

Policymakers should focus on strengthening the reliable ESI system, rather than advancing misguided policies that will cause catastrophic disruption.

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Recent Activity

Above the FoldSep 08, 2020 - 12:30pm

Washington State Public Option Fails to Deliver Savings to Consumers

Our VP of Health Policy explains why Congress should strengthen employer-sponsored insurance rather than a create a public option.

Press ReleaseAug 13, 2020 - 1:30pm

U.S. Chamber of Commerce Launches New Campaign to Bolster, Strengthen Support for Employer-Sponsored Health Coverage

Protecting Americans’ Coverage Together (PACT) aims to raise awareness of the perils that a public option or Medicare buy-in will have on the current and future workforce

ReportAug 13, 2020 - 9:00am
Cover of the Report "The Negative Economic Effects of Medicare for All and Medicare Buy-In Proposals"

The Negative Economic Effects of Medicare for All and Medicare Buy-In Proposals

This paper discusses recent proposals to expand Medicare and lays out the likely impact such a move would have on various stakeholders. For the sake of simplicity, this paper discusses Medicare for all and Medicare buy-in proposals, but the points apply more broadly.

ArticleJul 23, 2020 - 9:30am
New York Times building in New York City.

During the Pandemic We Must Bolster Employer-Sponsored Health Insurance

Now is a time for common-sense solutions, not radical changes.

Above the FoldApr 30, 2019 - 9:15am

Medicare for All Builds a Risky Contraption on a Cracking Foundation

Policymakers should fix the foundation first, before pondering additional risky reforms.

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