Small Business Health Insurance
Luigi Crevoisier writes:
For my second blog post, I attended a seminar on the affordability of health insurance for small businesses in Utah. This seminar was organized at the American Enterprise Institute (AEI), where Utah’s Governor Gary Herbert talked about the successful health insurance exchange for small employers in his state. [3] The topic of the talk was how the Health and Human’s Services (HHS) wants Utah to amend their health insurance exchange to comply with the Affordable Care Act. This topic was relevant for my topic because there has been a boom of Latino-ownership of businesses in Utah.
The issue of affordability is important because the cost of medical services in the United States is, as many of us know, very high, and people with insurance might have never noticed the cost of every single item in their bills. As an example, the Time magazine shows a medical bill where one accu-chek diabetes test strip costs 18 dollars when it is possible to acquire one of them for as little as 55 cents each on Amazon. [1] In that case, we are still in manageable numbers, but another case in the same page shows us a more scary- aberrant- number if a person is uninsured:
“The expensive technology deployed on Janice S. was a bigger factor in her bill than the lab tests. An “NM MYO REST/SPEC EJCT MOT MUL” was billed at $7,997.54. That’s a stress test using a radioactive dye that is tracked by an X-ray computed tomography, or CT, scan”.[1] Considering these costs, insurance in America is an imperative to access health care, and not having insurance can doom people for some years or the rest of their lives.[1]
|
Furthermore, the importance of affordability of insurance is vital for employers, especially the small ones. One of the main concerns of these months is the increase in premiums to come with the ACA. In Utah, there has been a Latino-owned businesses boom; from 2002 to 2007, there has been an increase in the number of firms from 5,177 to 9,221, meaning a 78.1% increase. Therefore, the issues pertaining health insurance in the Latino community are no longer relevant to them solely as employees but also as employers who own businesses. [1]
Utah has had the lead when it comes to health exchange since 2009, and in December 2012, the state declared their reform to their own program to comply with the ACA. Governor Herbert started his speech with a joke, and immediately followed with an example of a small business not being able to pay for health insurance for its employees due to the increased premiums, caused by the ACA. He addresses the rising costs of healthcare, and how Utah’s health exchange was able to provide personalized health insurance for employees and affordability for the employer. As a free market believer, Governor Herbert thinks that competition among insurance companies will bring down the costs of health coverage. He believes that public information, technology, and consumer’s choice are the best combination to keep a competitive health insurance market.
Summarizing his approach, Governor Herbert plans to focus on small businesses, so these can enroll its employees to private health insurance plans. The employees will be able to pick private health plans that cover their needs, which would save the business owner money by not having to pay for federal one-fits-all insurance. How do they plan to approach this? Governor Herbert has pointed out that when the ACA is fully implemented, Utah will not enforce the individuals mandate to enroll in the federal government program, will not administer Medicaid through its state program, and will not administer tax credit for the use of their state program.
After attending this event, I have learned that although surveys and studies show that Hispanics have one of the lowest academic attainment rates and many do not have a job that provides insurance in the US, the ACA implementation will not address the needs of Hispanic business owners. Policy makers should also take into consideration that when addressing Hispanic health insurance disparities, Hispanics will need assistance to access health care as employees but also as employers providing health insurance.
1 http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/2/
2 http://www.deseretnews.com/article/700048019/Latino-owned-businesses-booming-in-Utah.html?pg=all
It seems as though Governor Herbert presented an interesting case to justify Utah’s plan to share responsibility with the Department of Health and Human Services to comply with ACA guidelines. I very much respect the governor’s emphasis on continuing to seek market-oriented solutions that address the rising cost of health care while upholding Utah’s history of fiscal prudence. As you pointed out, although studies suggest that Hispanics have one of the lowest academic attainment rates and many do not possess jobs that provide insurance in the U.S., ACA implementation will not necessarily address the needs of these business owners. Combining cost control provisions with modest expansion coverage like additional coverage for children under the poverty line and keeping children on their parents’ plan until age 26 deem reasonable and necessary clauses. However, forcing individual mandates do not. The Utah Health Exchange model is a defined contribution program based on the principles of free market and consumer choice. What works and has worked in the state of Utah in terms of health insurance coverage may not be the same as what works in other states across the nation and Governor Herbert seems to have made this clear.