The Rhode Island insurance marketplace, HealthSource RI, is now up and running, thanks to a lot of great preparatory work. Tea Party ire as these “Obamacare” insurance marketplaces opened up around the country set off the government shutdown, a threat of U.S. default and considerable controversy. Rhode Island businesses now must sort through the confusion. I thank the local chambers of commerce, HealthSource RI, and the Rhode Island Association of CPAs, who’ve worked with the congressional delegation to sort fact from myth.
There has been considerable concern about how the law will affect businesses with fewer than 50 employees. Those businesses will get to use the marketplace, continue their employer contribution to their employees’ health care, and pay no penalty. It’s possible there will be strategic choices made around the 50-employee threshold, to postpone hiring or move employees to part time.
Bear in mind that 96 percent of Rhode Island businesses are below the 50-employee threshold. Of the businesses in America above that threshold, 90 percent already provide adequate health insurance to their employees. The employers who face that strategic choice are few. But this is an issue that bears watching.
The benefits for most small businesses are considerable. Ending the small-business disadvantage of little leverage in negotiations with insurers (rates are flat in the marketplace for all-size businesses), and ending the risk of one bad employee illness or injury knocking rates through the roof, should be advantageous. Small-business tax credits will help to defray the cost of the premiums. These benefits should be advantageous to small businesses.
The website problems have been serious, but are being sorted out. These problems were frustrating, but they were technical problems.
Against the challenges to large employers who provide no adequate health insurance, we must balance the value throughout our health care sector of less uncompensated care. And it’s not just money: There’s always a human face behind the nightmare of being uninsured.
I spoke to a doctor practicing in Massachusetts who before RomneyCare treated a 19-year-old cancer patient who maxed out her insurance coverage. She didn’t want to tell her parents about her cancer surgery, for fear that if they knew they’d sell their house to pay for the rest of her treatment. Her parents did find out, and of course did sell their home to pay for her treatment.
After RomneyCare, and now Obamacare, that doesn’t happen anymore. •