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.
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!
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.
MSA leaders say decision striking trigger provisions allows corporate players to buy political influence uncontested, at expense of small businesses
WASHINGTON, DC – On Monday, the U.S. Supreme Court issued a decision in McComish v. Bennett, a case testing some state public financing laws. In a 5-4 decision, the Court ruled narrowly that trigger-based matching funds provisions of some states' public financing laws are unconstitutional, while leaving the foundation of public financing systems intact.
The Main Street Alliance released the following statements from national spokespeople in response:
Jim Houser, owner of Hawthorne Auto Clinic in Portland, OR and MSA steering committee member:
This decision is bad for small businesses. We don't have the kind of money it takes to buy influence through heavy election spending the way big corporate players can. The Court's decision basically says to big corporations and their trade groups, 'Go ahead, spend all you want to buy elections, and if anyone tries to limit the corrupting influence of your activities, we'll run interference for you.
The silver lining is that the decision leaves the basic structure of public financing systems intact, reaffirming that small dollar public financing laws are a legitimate way to combat corruption and promote free speech. Establishing small dollar fair elections laws is a critical way to take corporate corruption out of elections and restore integrity to our political system.
David Borris, owner of Hel’s Kitchen Catering in Northbrook, IL and MSA executive committee member:
This decision goes against the very idea of America as the 'land of opportunity.' It means big spenders, many of which are big businesses, will be able spend massive sums of money to flood election debates and drown out the interests of small businesses like mine. It means corporate heavy hitters will continue to be able to buy influence by tipping the scales of elections with their campaign spending, then rewrite the laws of the land to favor their narrow special interests at the expense of small businesses - and everyone else.
New research released today re-confirms two key points that small business owners who've been fighting for health care reform knew all along:
- First, that employer health coverage has been on the decline for the last decade, and small businesses have been feeling the squeeze more than anyone.
- And second, that provisions of the Affordable Care Act are going to bring health coverage within reach for a lot of small business owners who want to offer coverage but haven't been able to.
This second point is real good news for small businesses, and it comes in an Urban Institute report released today by the non-partisan Robert Wood Johnson Foundation (it's refreshing to see some real research after the circus show over the controversial McKinsey & Co. "study" that has been thoroughly debunked over the past week).
The Urban Institute study forecasts that insurance offer rates for firms with 100 or fewer employees will increase by nearly 10 percent thanks to the Affordable Care Act's health insurance exchanges and other insurance market reforms. Firms with fewer than 10 employees are expected to see the biggest jump - an increase of more than 14 percent. Talk about delivering big for small businesses!
Of course, many important decisions remain to be made about how states will set up their new insurance marketplaces, or exchanges. Main Street Alliance leaders are actively engaged in states from Maine to Oregon to promote exchanges that maximize on the opportunity to make quality, affordable health coverage available to all small businesses.
The Main Street Alliance submitted a letter from small business leaders in its network opposing a mandatory expansion of the E-Verify system for the record of a June 15 hearing on the topic. House Judiciary Committee Chairman Lamar Smith filed a mandatory E-Verify proposal on June 14.