Three small business owners told a Senate hearing Tuesday that Obamacare is riddled with problems that are leading to more expensive insurance policies, which is making it harder for companies to provide high-quality healthcare to their workers.
Thomas Harte, owner of Landmark Benefits in New Hampshire, told the Senate Health subcommittee on Primary Health and Retirement Security that the Affordable Care Act makes healthcare more expensive for small business owners.
For example, because the ACA bases the price of coverage on age, it is considerably cheaper to hire a younger person. Harte said that hiring a single, 25-year-old worker would cost $385.57 per month for their insurance premium versus $1,046.44 for a single, 60-year-old. He said that makes it more difficult to higher people with more experience.
Additionally, "available carrier choices are becoming more and more limited" as the medical care costs differ between states, and "health reform implementation" also varies between areas. Some states do not require companies to adopt all of the reforms under Obamacare while others phased out "grandfathering" and demanded all small companies to discard their old insurance and purchase new plans that fully embrace Obamacare changes, Harte said in his statement.
James Scott, owner of Applied Policy in Virginia, said in his written statement that the insurance premium rates change every year, which makes it difficult to run a business. He said the health care system should "have recurring expenses like health insurance premiums be predictable."
Scott said that, as a small business owner, he has experienced this sudden change in costs of healthcare. In July of 2014, he went to renew his insurance plan with his insurance broker. She told him that his plan had been designated as a platinum plan, and the insurance premiums increased by 40 percent. Again, because of the age-basis for coverage, his broker had to have seven different meetings with each of his employees in order to discuss their individual upcoming coverage options.
"Please keep in mind that our employees want stable and predictable coverage so they can keep their doctor from year-to-year, become comfortable with benefits and the cost-sharing obligations, and have confidences that if they have to go to the hospital, their insurance coverage will help pay the costs," Scott said. "I want my employees to have that kind of coverage so that they can focus on work, get healthcare services when they need to, and not worry about their health insurance coverage."
Kelly Conklin, owner of Foley Waite LLC in New Jersey, told the subcommittee that he supports the Affordable Care Act, and said he does not support a repeal of ACA or any extreme amendments that essentially repeal the law. But even he said it needs some adjustments to better benefit small businesses.
Conklin said that choosing coverage "can be a daunting experience," especially for a small business owner who is unsure what coverage is most suitable for his employees. He said the plans would be easier for small employers if there was more transparency, or if they were written with less confusing language. A "window" into actual ACA costs would also be beneficial as it would allow business owners to determine if they were running a profitable business, he said.
He said that "quality and availability of care continues to decline" even after the law took effect.
"Until every American has a card in their purse or wallet that guarantees access to a doctor — any doctor, anywhere, until emergency rooms only serve emergency patients and not emergency patients and the uninsured, I and my employees will pay too much for too little," he said.
The ACA created the Small Business Health Options Program (SHOP) so small businesses can shop for health insurance in the Obamacare marketplace. But Sabrina Corlette, senior research fellow and project director at Georgetown University, said these SHOP exchanges have plenty of IT problems to the point that "it might be kind to say [they are] non-functional."
"With few exceptions, the SHOPs have been slow to get off the ground and enrollment has been low," Corlette said in her statement. "During the first year of operation, only a minority of states had the technical capability to offer on-line enrollment, and fewer still prioritized the SHOP in their marketing and outreach campaigns."
Efforts to make employee choice mandatory were delayed in 2014 and 2015, so there are only 32 states with "some form of employee choice" this year, she said. However, all 50 states should be participating in 2016.
The process to enroll is long and tedious making it detrimental to insurance brokers' profits and not worth the arduous process for companies seeking a tax deduction. Even so, healthcare cost growth has slowed, she said.
"All employers, including small employers, are benefiting from the unprecedented slowdown in health care cost growth," Corlette said in her statement. "Since the ACA was passed, we have seen the slowest growth in health care prices in 50 years."
All three small business owners agreed that they just want a healthcare system where they can afford to provide their employees with quality healthcare without breaking the bank or drowning in paper work.
"My employees want access to providers, a good benefit package and fair premiums and cost sharing. As an employer, I want to provide that to them. More could be done to help employers and employees compare the total costs of coverage rather than choose the lowest premium plan and be surprised by the high out-of-pocket expenses when they visit the doctor," Scott said in his written statement.