role of business and organized labor in the maintenance of private health insurance in the United States

Business and organized labor in the US have been historically involved in health insurance through employment, in absence of a universal health care system. This employment-based healthcare system remains the dominant form of coverage for Americans today although its importance has been declining over the long-term. Over the last decade and after the passage of the Affordable Care Act, employers and unions have sometimes been challenging the system. But the convergence toward a universal system is likely to be a long process.