For workers in Arizona, the question of whether health insurance is a right or a privilege is complicated. Many assume that employment means guaranteed health coverage. However, that’s not always the case.
Employers are not legally required to provide health insurance in every situation, and coverage often depends on the size of the business and the employee’s status. Understanding how state and federal laws apply can help workers know what benefits they’re entitled to and what options they have if coverage is denied.
What Is Health Insurance and What Does It Cover?
Health insurance is a contractual agreement in which an insurer agrees to pay for some or all of a person’s healthcare costs in exchange for a monthly premium. It serves as a financial safety net that protects individuals from the high costs of medical care, which can include everything from routine checkups to emergency surgeries.
Health insurance policies vary in scope and price, but they typically cover a range of essential health benefits.
What Does the Affordable Care Act Cover?
Under the Affordable Care Act (ACA), all health insurance plans offered in the individual and small group markets are required to cover a standard set of essential health benefits.
Covered services include:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services
- Pediatric services
These core benefits ensure a baseline level of coverage, though specific plan details may vary.
Federal vs. State Laws
Under federal law, particularly the ACA, employers with 50 or more full-time equivalent employees are required to offer health insurance or face a tax penalty. This law does not necessarily create a right to health insurance, but it does establish a legal obligation for qualifying employers.
Arizona does not mandate that employers provide health insurance benefits beyond what federal law requires. There is no state law that creates an independent right to health insurance for workers. In other words, unless federal law applies (e.g., through the ACA), employers in Arizona are generally not required to offer health insurance.
At-Will Employment and Benefits
Arizona recognizes the doctrine of at-will employment. An employer can terminate an employee at any time for any lawful reason. This system also allows employers wide discretion in deciding what benefits to offer, including health insurance.
Although many employers voluntarily offer health insurance to attract and retain talent, this is not a legal obligation unless they meet the ACA threshold. Workers employed at small businesses (with fewer than 50 employees), independent contractors, part-time employees, and gig workers often fall through the cracks of employer-sponsored health coverage.
Public Employees and Union Contracts
Some categories of workers in Arizona do have greater protections. Public employees, such as teachers, police officers, and state government workers, are typically offered health insurance as part of their employment packages. However, this is an employment benefit, not a statutory right.
Similarly, unionized workers may gain health insurance coverage through collective bargaining agreements. These contracts may impose legally enforceable obligations on employers.
Coverage Outside Employment
For workers not offered insurance by their employers, Arizona residents have access to the federal health insurance marketplace at HealthCare.gov. Through the marketplace, individuals may qualify for subsidies based on income, and some may qualify for Arizona’s Medicaid program.
The availability of subsidized or free coverage does help fill the gap for many low-income workers, but it still requires proactive enrollment and, in some cases, cost-sharing.
Contact the Phoenix Employment Lawyers at Houk Employment Attorneys for Help Today
In Arizona, health insurance for workers is best described as a right in some cases and a privilege in others. It is a right under specific circumstances, such as working for a large employer or being covered by a union contract. Outside those situations, there is no blanket legal entitlement to employer-sponsored health insurance.
If you’re having an issue with your employer, Houk Employment Attorneys is here to help. Contact us today for an initial consultation with a Phoenix employment attorney.
Our employment law firm is conveniently located near you, with an office in Phoenix, AZ.
Houk Employment Attorneys
1850 N Central Ave Suite 2010, Phoenix, AZ 85004
(480) 569-2377
