They could even do this without too many major changes. Just three in fact:

- Increase HSA Contribution Limit

- Allow both Traditional & High Deductible insurance premiums to be paid with the HSA

- Ban employers from directly providing/choosing insurance (ex. US Military)

Essentially everyone goes out onto the open market and buys their insurance using pre-tax HSA contributions (similar to tax benefits to employers now). Employers can continue to "help" be providing dollars to HSA/HSA match, rather than picking your insurance for you.

There are more radical and arguably better solutions, but if you want to see a large improvement with minimal changes/the least controversy this is it. Most insurance companies could likely just convert existing employer provided policies into employee direct ones paid via HSA.

You're assuming people have the money to contribute to an HSA and an employer when many do not.

I am talking about a solution to separating employers from your choice of insurance policy, you're talking about an entirely different issue.

I said there are other, arguably better, solutions (e.g. universal coverage) whereas this is an attempt to solve a near-term issue of employer provided health insurance.

If you can get the political support to pass universal reform to health coverage in the US, then absolutely do that instead. In the current political climate this compromise is still a vast improvement.

In 2019 the Trump administration made a change allowing HRA plans to pay for insurance premiums. That went into effect on Jan 2020. That effectively allows a small business to take part/most/all of the employee’s insurance burden from the individual market (healthcare.gov) onto their expense sheet rather than the employee paying for it with post-tax dollars. The problem of course is that in a number of states the individual market plans are still pegged to the price of unobtanium, but it’s a good step forward. The particular vehicle is called an ICHRA.

Is there any momentum behind these ideas? I don't have any idea what the state of US healthcare reform is.

Nope.

The current "war" is between complete re-invention and essentially the status quo. This is neither of those, therefore it upsets both sides, and gets squished by "perfect is the enemy of good."

Yes, at least two big changes were attempted in last administration with 50% success rate. First, loosening restrictions on association health plans which would have allowed diverse groups of small businesses in an area to band together to negotiate lower rates as if a larger organization. This was struck down by the federal court.

The second, and successful, move was to allow health reimbursement accounts (HRA) to pay for insurance premiums on the individual market. These plans, an ICHRA, would allow a small business to essentially give pre-tax dollars to the employee for buying health insurance as long as the reimbursements were applied consistently across the employee base.

The second was great, but the first would have been even better since it would have lowered group rates. Individual insurance premiums and deductibles (when not subsidized by gov) are often so expensive they are hard to justify. Still ICHRA’s are at least another tool for employers and employees to share the burden.

You know that your dream is actually the standard in every developed nation except the US right?

That's what makes it seem achievable.

That is more or less what we have in France, it comes with other issues... like really high taxes.

But we have many start-ups, which usually migrate to the US as soon as they grow big.