More health care choices for small businesses

As the leader of the Universal Health Care Foundation of Connecticut, it goes without saying that I want our state to take bold action to ensure that everyone in Connecticut has access to affordable and quality health care.

This legislative session offers an opportunity to do that. House Bill 7267 and Senate Bill 134 offer the prospects of new, more affordable insurance choices for small businesses with fewer than 50 employees. These two identical bills would also extend more choices to individuals who struggle to buy insurance on their own and don’t qualify for public subsidies.

The Office of the State Comptroller negotiates health coverage with the insurance and pharmaceutical industries for nearly 250,000 state employees and retirees. Like other large employers, the state has strong negotiating power. These new plans would be negotiated by the Comptroller’s office and would be customized to the small employer and individual markets. While not exact replicas of the state employees’ plan, they would benefit from the state’s negotiating leverage to increase their affordability and drive down underlying prices.

The Foundation is a small nonprofit business that prides itself in offering our staff the best coverage we can afford. Over the years, increased premiums in the small group market have made maintaining our coverage a struggle.

We aren’t unique in our experience. Small businesses and nonprofit organizations with fewer than 50 employees struggle to afford health coverage for their employees. Three pressing themes emerged from recent focus groups held right here in Connecticut with small business owners.

1. They lose good employees to businesses and nonprofits who can offer better health care benefits.

2. The small group market is failing them — they can’t offer coverage affordable to their employees and they can’t predict how much health care will cost them over several years, so they can prepare accordingly.

3. They think it’s reasonable for the state to offer additional choices that they can evaluate alongside private insurance choices.

H.B. 7267 and S.B. 134 were voted out of the Appropriations Committee and are on the calendar to be debated by the Connecticut House of Representatives and Senate this month.

Small businesses, nonprofits and individuals in Connecticut need and want the positive impact of more affordable coverage than they have now.

Our elected leaders are under significant pressure from the state’s budget challenges. They hear from employers that Connecticut needs to be more “business-friendly.” Expanding health care choices would go a long way on both fronts. According to the Small Business Administration, small businesses employ more than 700,000 people. That’s nearly half our workforce. Insurers employ about 60,000 people, according to the Connecticut Business and Industry Association — but only a fraction of a percentage of those employees work on coverage specific to the Connecticut market. As their opposition makes clear, they don’t seem to like the idea of more competition. Yet healthy competition in health insurance will help small businesses grow and thrive.

Furthermore, according to the Connecticut Department of Insurance website, Anthem and ConnectiCare are the predominant insurers in the small group market. Yet Aetna, which reports covering only 7,500 lives, and CIGNA, which does not serve the Connecticut small business market at all, have launched a full-court press urging their employees to write their legislators opposing “the public option!”

Carriers claim that the small group market is volatile and risky, requiring substantial reserves to manage unforeseen utilization. Maybe that is true, but perhaps the real problem is that carriers can’t realize the profit margins they seek from this market — and that is why many of them already don’t participate in it.

In contrast, the Comptroller’s office doesn’t have the goal of making a profit and instead seeks to have quality, affordable coverage available to more Connecticut residents.

Our elected leaders need to help our small businesses thrive and take bold action to get this done.