NASE on Micro-Business

Posts Tagged ‘mandates

From day one the Obama Administration has been touting that they were going to foster a different kind of government. Transparency, participation and communication were going to be front and center. As I work on health care reform however, it is evident that Congress unfortunately didn’t get the memo on this new citizen-friendly, collaborative process.

Recently, I spoke about the micro-business perspective on mandates at a briefing sponsored by the Coalition for Affordable Health Coverage. In my concluding remarks, I highlighted that our recent survey of micro-businesses showed that while they want government involvement in regulating the insurance market, they did not want the federal government to provide coverage. In other words, thumbs down for the public option. Needless to say, shoes almost started flying from some of the audience members and I received some heated comments during the question and answer period. Sadly, this was not the first time I have experienced this reaction when the topic of the public option is raised amongst its staunch supporters.

Now, I certainly don’t want to be a partisan complainer. I’ve had similar experiences with staff from the other side of the aisle when discussing additional health reform recommendations such as mandates and market reforms.

Aren’t we able to disagree respectfully? Shouldn’t all voices be heard, not just the ones that agree with you?What is so disheartening is that the self-employed and micro-businesses want reform. No, we NEED health care reform. In fact, we support almost every other reform recommendation out there – such as creation of an exchange or connector, cooperatives, market reforms like guaranteed issue and even mandates with the right mix of subsidies and cost containment mechanisms. Yet, it seems that all bets are off because we prefer to get our health insurance from a private insurer versus the federal government.

Maybe we can’t do it all when it comes to health reform, but there are options on the table that we all agree on that can really help our small business owners. A difference of opinion on one issue should not preclude collaborating and compromising on a reform approach. Yet the ire of both political parties is brewing and bubbling up regarding health reform, threatening to undermine any chance of providing micro-business owners and all Americans with access to meaningful, affordable coverage.

My outlook can be summed up in one word: disappointment. We were hoping for change, we were promised change yet it seems like all we are getting is more of the same from Congress.

Since health care reform has risen to the top of the priority list for the Obama Administration and Congress, I spend a lot of my time trying to insert the self-employed perspective into this debate.  I will tell you that often this is not an easy task.  As of late I have been asked quite a bit about the National Association for the Self-Employed’s perspective on mandates. Congress has been batting around the idea of including in a health reform bill an employer mandate, requiring employers to provide and share in the cost of health insurance for their employees, and/or an individual mandate, requiring all individuals to purchase health coverage.  This idea received significant traction when major insurers announced they would support some key market reforms in exchange for the inclusion of an individual mandate.  This week, the fervor around mandates was kicked up a notch when President Obama indicated in an open letter to key Senators that he is amenable, with a few exemptions, to proposals for “shared responsibility — making every American responsible for having health insurance coverage, and asking that employers share in the cost.”

According to a June 2008 study by the NASE, only 18% of micro-business owners (10 or less employees) in our nation are currently providing health coverage to their employees.   Thus, the majority of the self-employed are purchasing health coverage in the individual market.  The biggest concern amongst the self-employed and micro-business is affordability of health coverage.   In addition, micro-business owners with employees also worry about the administrative burden of managing health care for their workers.  This segment of the business population believe that if reform proposals don’t include adequate cost containment measures or financial assistance such as health tax credits yet include a mandate requiring all to obtain coverage, they will be worse off than they are now.  And with the economy struggling as it is, forcing the self-employed to purchase coverage or provide coverage to their workers could mean the difference between staying in business or closing their doors.  Therefore, NASE members do not support mandating coverage at the present time.


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