I find it incredible that people believe that small businesses are not big enough, not smart enough, or not equal enough under the law to have the same rights as big business and big government. For some reason, it is ok for the GIC to get bigger and to achieve savings through wellness activities, broker fee avoidance, etc. But for some reason, the same rights are not available to small businesses, and shouldn’t be because they have to subsidize the costs of someone else. We force small businesses and their employees to subsidize non-group purchasers currently gaming the system, as well as non-US citizens, etc. A small business wants to institute a wellness program? Go ahead, but it won’t save you or your employees one dime as your group gets healthier and claims drop. The benefits acrue to the insurers and their bigger clients. Don’t use a broker? Too bad. You still have to pay fees as high as 10% for a service you don’t use.

I don’t see big business or big government having to cover costs other than their own. The GIC, cities and towns, and big businesss do not cover any costs of non-group gamers of system–just small businesses. Make no mistake about it. The current system is discrimatory against small businesses and their employees and it will be the downfall of “Health Care Reform” in Massachusetts unless changed and changed soon.

Those that advocate for the current system are no friends of small business owners and their employees in Massachusetts.

BCBS of MA is all over town lobbying to prevent the requirement that cities and towns go into the GIC. Their arguments make sense until applied to small employers and employees. For some reason, they argue the same rules shouldn’t apply to the little guy. Their lobbying is ethically challenged, and represents contradictory public policy positions at best.

Family policies for small businesses versus big government and big business in Massachusetts are as much as a whopping $10k difference today. This is a crisis; this is scandal; and it must change NOW!.

The current discrimination cannot be sustained either economically or politically. And all the foundation money, directors fees, and company money of big payers spread around Boston will not change that fact.

Jon Hurst
Retailers Association of Massachusetts

We couldn’t agree with you more on the problems with Association Health Plans and wanted to offer another problem with them. They do nothing to address rising health care costs.

A better approach is the proposal that Sen. Richard Moore and Rep. Harriett Stanley unveiled in mid-July and was reported on by Martha Bebinger (A Plan To Ease Health Insurance Costs For Small Businesses, Wednesday, July 15). The proposal – The Affordable Health Plan – would provide immediate relief to small businesses and consumers and reduce premiums by as much as 22 percent by getting at the cost of health care.

The proposal sets a standard benefit package on par with the Health Connector’s Commonwealth Choice Bronze level, which is similar to the benefits that many small employers now provide. It would cap reimbursement rates to providers for this product at no more than 110% of Medicare and it would limit insurer profits on all products sold to individuals and employers with 50 or fewer employees. For more on the plan, visit http://www.mahp.com/news/costcontrol2.html.

Reducing the premium by 22 percent would generate significant savings for small businesses. For example, the lowest-priced Bronze package for a family of four, with two 40-year-old parents and two children living in Boston, is $822. Cutting the premium by 22 percent would save $180 per month or nearly $2,200 a year. For a small business, those savings can add up pretty quickly.

The bulk of the premium dollar – nearly 90 cents – pays for medical care, including doctor visits, prescription drugs and hospital stays. Tinkering with the rating rules or exempting groups from the small group law does nothing to address those costs. The Affordable Health Plan does and would go a long way to help small businesses.

A number of employer groups that represent small businesses support the proposal, including the Worcester Regional Chamber of Commerce, Small Business Service Bureau, the Smaller Business Association of New England, Massachusetts Business Association, and the Massachusetts Association of Health Underwriters. They talk with small businesses all day long. They know the challenges small businesses face and the difficult choices they have to make at renewal. Their support tells us that this is the right thing for small employers.

The Affordable Health Plan wouldn’t fix everything in health care and would be a short-term solution while the health care system works to implement the Payment Reform Commission’s recommendations. But small businesses can’t wait, nor should they. The Affordable Health Plan would go a long way to helping individuals and small businesses while the rest of us in health care work on the longer-term issues.

Individuals can only pay so much for coverage before their breaking point. Carriers routinely lose money on individuals but make up for it in the small group market. If a biz decides to implement wellness programs such as stop smoking or weight loss and these are successful, his biz receives no financial benefit from the insurance market for his reduced claims. Since the state has removed underwriting, especially the ridiculous no rate up for smokers, carriers and businesses have no incentive for wellness programs.

As long as costs and utilization from individuals continue to rise, small groups will continue to look for solutions like this to contain their health care costs