Rep. Glenn Grothman, R-Wis., wants to require ERISA plans to close the gap between the patients' cost for the oral and IV versions of chemo drugs.

"Low and middle-income workers rely on those other forms of coverage, because they can't rely on access to employer coverage as companies outsource certain functions to contractors or hire more employees in roles that aren't eligible for benefits," said Dr. Sumit Agarwal, an assistant professor at the University of Michigan Medical School and School of Public Health.

"If the first obligation of a health care system is to take care of the sick, we are failing that test," said Dr. Drew Altman, founding president and CEO of KFF.

Trust is built over time, and payroll is one of the clearest places where employees see whether that trust is deserved.