Changes are finally coming to states’ health insurance marketplaces. For small businesses, these changes can’t come soon enough. New rules prohibiting discrimination and strengthening oversight of rate increases will protect small businesses from rate shocks. A guaranteed essential benefits package will provide assurance of a minimum level of coverage. And new state insurance exchanges will enhance choice and competition.
But there’s one segment of many states’ insurance markets that is looking to dodge these new rules: association health plans (AHPs). AHPs are coordinated by membership associations – for example, state and regional chambers of commerce. Indeed, some state chambers are among the groups pushing to shield AHPs from having to play by the same rules as other health plans as the Affordable Care Act’s market reforms phase in.
But who really wins if association health plans are allowed to skirt market reforms and thumb their noses at the new rules?
Unregulated AHPs threaten the success of the new state insurance exchanges: by cherry-picking out the youngest and healthiest enrollees, they could stick an exchange with an older and more illness-prone population. That’s clearly not good for any small business participating in the exchange.
On the flip side, businesses getting their health coverage through AHPs won’t have the benefit of the ACA’s new protections – they’ll still be subject to rate discrimination, unreviewed rate hikes, and “thinsurance” (policies with such skimpy coverage they’re barely worth the paper they’re written on). It’s hard to describe that as “winning,” either.
The real winners from allowing AHPs to continue unregulated? The insurance companies (who get to keep doing business as usual, as if health care reform never happened) and the associations that make a regular income from marketing AHPs to their members.
The solution? That’s easy enough: make AHPs play by the same rules as any other health plan in the small group or individual market. Some groups that sell association plans to their members will undoubtedly lobby tooth and nail against this idea, but if they do they’re putting their own bottom line ahead of the best interests of the broader community – not to mention their own members.
The Main Street Alliance voted recently to officially endorse a new issue: paid sick days. Why do small business owners care about this issue? For a wide range of reasons - like workplace productivity, public health, and a commitment to treating workers like family. In short, it seems like the right thing to do... and it makes good business sense, too.
The productivity case alone is a strong one. According to the Center for Worklife Law, "presenteeism" (employees going to work even though they're sick) costs U.S. employers and the U.S. economy an estimated $180 billion a year in lost productivity. When workers don't have access to earned sick time, they're more likely to go to work sick, risk infecting co-workers (and potentially customers), get less done, and take longer to get back to 100 percent.
We'll be posting periodic updates about paid sick days in the weeks and months to come. In the meantime, if you're looking to learn more, check out this nifty infographic from medicalinsurance.org.
Brianne Harrington, owner of The Painted Pot in Helena and a leader with the Montana Small Business Alliance, had an op-ed printed in the Helena Independent-Record making the case for implementing the new value for premiums (medical loss ratio) requirement.
We won’t fix our broken health care system if we allow insurers to cook the books and go on doing business as usual. We need our health insurance companies to approach the premium value requirement as an opportunity to find ways to increase value and cost savings for their members, instead of trying to circumvent it.
Small business owners focus our best energies on providing good value to our customers every day. We deserve and expect nothing less from our health insurance companies.
Ground-level ozone - commonly known as "smog" - harms public health and worker productivity. Ozone reduces lung function, inflames airways and aggravates respiratory problems like asthma and lung disease. According to the EPA, strengthening ozone standards will annually prevent or avoid up to 58,000 asthma attacks, 21,000 hospital and ER visits, and 420,000 lost work days.
But efforts to strengthen these standards are under attack by major polluters using an old trick - hiding behind small business. The Main Street Alliance is inviting small business owners to sign a letter to the White House to demonstrate that you support clean air and strong ozone standards to protect community health and productivity.Please join us in signing on!
During the last Insurance Exchange Meeting on June 27, 2011, draft legislation for an Idaho Health Insurance Exchange was presented for stakeholder input and comment. The Idaho Main Street Alliance has the following concerns with the draft legislation and its compliance with the Patient Protection and Affordable Care Act. Click here to read more.
Idaho Main Street Alliance member Dave Silva: “Say no to insurance representatives on the Idaho Health Insurance Exchange Governing Board.”
Idaho Main Street Alliance member Dave Silva, owner of Automated Office Solutions in Boise had a letter to the editor published in the Idaho Statesman on July 18, 2011.
Click here to read the Letter to the Editor.
New Jersey Main Street Alliance leader Jacquie Germany, owner of Nina's Nuances Interior Design in Montclair, NJ, had a commentary published in the Washington Post on July 10 in support of financial reform and the new Consumer Financial Protection Bureau. Jacquie writes:
Small businesses have been devastated by the economic consequences of Wall Street recklessness and abusive lending, with the recession leading to small-business bankruptcies nearly doubling between March 2008 and March 2009.
And small businesses are especially hurt when dollars that our customers and prospective customers could be spending on the goods and services we offer are instead sucked away by bad mortgages, or deceptive credit cards or outrageous overdraft fees.
If upheld by full NAIC, recommendation would gut MLR requirement, hand almost $1 billion in small business and individual rebates back to insurers
Washington, DC – Today, a work group of the National Association of Insurance Commissioners (NAIC) voted to recommend NAIC endorsement of a legislative proposal that would undermine the Affordable Care Act’s minimum medical loss ratio (MLR) requirement by removing agent and broker commissions and fees from the calculation of administrative costs. The Main Street Alliance released the following statement in response:
Kelly Conklin, owner of Foley-Waite Associates, Inc and a member of the Main Street Alliance Steering Committee:
"Today’s task force vote was a very good vote for big insurance and a very bad vote for small businesses. The task force voted to take almost $1 billion in annual rebates to small businesses and individuals and just hand that money right back to the health insurance companies, no questions asked. That’s a real poke in the eye to Main Street.
"The value for premiums requirement is one of the key benefits of the new health law for small businesses. It should be implemented as written, not undermined to bail out the health insurance companies from having to fix their broken business model. If the full NAIC takes into account what small businesses need, they’ll vote to overturn this misguided recommendation and support the value for premiums requirement as written."
The Main Street Alliance submitted a letter on June 28 to the task force outlining the importance of the MLR requirement for small businesses and urging the task force to recommend no change to the requirement. Download a copy of the letter here.