Comment by trashface

The ACA would need to be changed too, it isn't as generous tax-wise as employer based care. The portion of the premium paid by the subscriber is not automatically tax deductible - they have to itemize or meet certain self-employment restrictions. Many don't, so they are paying effectively with after tax dollars. Its one reason why the ACA rate hikes next year are so brutal.

It matters for early retirees (or these days, people forced out of job some years before they wanted to officially retire). Without self-employment income they can't deduct it, and often for similar reasons they can't itemize. They still get the standard deduction of course, but an person on an employer plan gets that + their cost of premiums, automatically.