Posted by marykeating on October 30, 2009 under Employment benefit issues, Pending legislation | 
The Secretary of Health and Human Services released a report explaining in very clear language the effect of health insurance reform on the ability of small businesses to offer health insurance. According to HHS’s report, 56,593 small businesses in Maryland alone would qualify for an attractive tax credit. In addition, health insurance reform would end the catastrophe that effects some businesses when insurers hike premium costs as a result of an illness or injury of even a single worker. Small businesses have been rated by their own experience. So when one person of 50 has a serious illness, incurring hospital care, the rates for the business are directly affected. For a huge business, an illness or two does not alter the experience very much, because of the law of averages. But small businesses can be forced into giving up insurance benefits if two people are diagnosed with cancer.
The new law, if it passes, would forbid rating based on health status. In the end, the law of averages across the spectrum of the state or the country will drive insurance prices. In addition, the new law would end the lifetime cap on insurance benefits. This was an issue advocated by the late Christopher Reeve, who would not have made the progress he did without personal resources.
Finally, the law would end the practice of discrimination against women. There are insurance plans that refuse to cover women of child-bearing years, or treat pregnancies as uncovered conditions. (Maryland law is stronger than some states, and does not permit a blanket prohibition against insurance for childbearing.)
The economic hardships that have befallen many employees and businesses have brought some of these issues to the forefront. I hope we have the fortitude to make some much-needed reform to the existing system.
Posted by marykeating on July 22, 2009 under Employment benefit issues |
The Baltimore Sun reported this morning on a non-scientific poll of small businesses conducted by the Public Interest Research Group. Small businesses often find themselves unable for financial reasons to offer health insurance as a benefit, even where employees pay a portion of the costs of coverage. Local businesses are similarly hamstrung. Those that offer insurance do so as a way of attracting the caliber of employees they need, but apparently are not doing so happily.
The cost of health insurance has risen steadily over the past few decades, faster than inflation; perhaps only college tuition prices have shown a similar independence of the inflation rate. According to the National Coalition of Health Care, premium costs for a family of four topped $12,000 per year. It’s no wonder that many employers do not offer insurance coverage, or require employees to pay an increasing share of it. In an era when wages are not rising, this hurts, though not as much as not having insurance at all. Then, when an employee becomes unemployed, COBRA or its state equivalent requires the employee to pay the entire cost, plus a 2% administrative fee. (But see the limited period of relief that Congress has granted.) Still, COBRA ends after 18 months, after which the employee’s options are often limited to a state health pool, or a private plan.
When did health insurance become a common fringe benefit? It is somewhat arbitrary that the American worker or her family is dependent on a certain type of job (full-time, with a larger company) to enjoy health insurance coverage. Apparently during World War II, the government had to approve wage increases. In order to attract workers some companies added attractive fringe benefits. Unions, likewise, bargained for generous health insurance coverage. Sixty years later, the climate has changed dramatically. Perhaps the time is right for a centrally provided health insurance agency. Then we’ll see how the large companies use the savings.
