I was fortunate to travel to Washington D.C. recently with a group of people who are concerned about health and access to health insurance. While there were many sectors represented at our meeting, the overall theme was the same: small businesses want to have a healthy workforce, and recognize the importance of insurance coverage. There’s no doubt that the landscape of choices to make that happen is changing.
Many small employers are looking to the Affordable Care Act to see what options exist to provide health insurance for their employees.
For employers that have never been able to afford to offer coverage, the marketplace is a convenient option for their employees to purchase insurance — a first for some of these people.
Before the marketplace, these employees had to research and find single or family policies and could be declined for pre-existing conditions. Now, they are part of a “large group market” of people purchasing through the marketplace and get the benefit of much lower premiums and better coverage.
Some small business owners who already were offering health insurance chose to take an early renewal option with their existing insurance provider because of the uncertainty that accompanied the roll out. Next year, however, they will begin to examine all of their options.
The Small Business Health Options Program or SHOP Marketplace is designed to offer a place for businesses with fewer than 50 employees to shop and compare qualified health insurance products. This is also the way for these businesses to qualify for tax credits. Unfortunately in Missouri, there is only one insurer offering SHOP marketplace plans at this time. In Kansas, there are two.
The Department of Health and Human Services is working to help make these options more robust so that shopping will offer a real choice. So while this remains a work in progress, it was encouraging to hear that other states have seen some success, and it is likely that Missouri and Kansas will, too.
So who is still left behind?
Medicaid coverage for low-income workers is a critical piece that is missing right now. Seventy percent of those in the “coverage gap” — who would qualify for the new Medicaid but don’t qualify for subsidies in the marketplace — are working, and many of them in small businesses.
Medicaid could take the burden off small employers to provide coverage to those who have incomes up to 138 percent of the Federal Poverty level (up to $15,300 for a single person household) by the expansion of Medicaid in Kansas and Missouri.
Small businesses are important economic drivers. Ensuring that their employees have access to affordable health insurance, and thus good health, is critical. I am encouraged to hear about the progress being made to increase opportunities for workers.