Employer-sponsored health insurance historically offered access to affordable health care to many Americans of every social and economic class. Everyone from a janitor to the chief executive officer could access new advances in care. Even those with modest salaries could afford medical access for childbirth, hernia repairs, gall bladder removals, and children’s broken limbs. But low-wage workers face particular challenges in the current approach to health care financing. The good news is that there are specific actions employers and other health care purchasers can take to address the problem.