I think it is worthwhile to point out that the Massachusetts employer community has helped prevent such a challenge to this point because earlier policy decisions did not put our jobs, our employers or our economy at jeopardy. Everyone was working together to make this reform a success, which it has been to date on coverage, but not yet on cost. Unfortunately double digit premium increases have continued for small businesses; and state promises of provider transparency and lower cost small business health plans through the Connector are undelivered. On top of those costs and slow state reform implementation comes new quarterly filings, and tougher compliance standards.

The proposed “fair share” changes would trigger an unfair small business tax even though those small employers are disciminated against on health insurance pricing versus big business and big government. And the proposed Minimum Credible Coverage changes somewhat arrogantly seek to dictate to employers across the country what their plans should look like here and elsewhere. For national employers with jobs in the Commonwealth, are you really going to give your MA employees better coverage than those in NH?

Incredibly the fair share change will result in thousands of employers (primarily small businesses) having to pay the tax simply because they cannot make the 25% participation rate. (Small employers have lower participation rates because their premiums are more costly than those of big government and big business, so if you are a dual earner family, with one working for a big employer and one for a small business, which plan are you going to choose?)

That tax will be imposed despite the facts that they made offers of insurance to all of their full-timers, and that they have made substantial co-premium payments. But many small employers simply can’t reach that 25% threshold due to high premium costs or the demographics of their staffs (such as having many secondary wage earners on spouses’ or parents’ policies or retirees on Medicare). The tax will be assessed on all of their employment. That includes part-timers, those that they insured, and those that have insurance coverage elsewhere.

Why offer health insurance at all if you are going to be taxed by the state regardless of the fact that you are currently offering coverage and paying premiums? So the Commonwealth will raise new tax dollars, but less people will be insured because employers will stop making their offers and will simply pay the tax rather than pay both the tax and premiums. That is a counterproductive policy which doesn’t make any common sense. It punishes thousands of small employers that have tried to do the right thing over the past two years.

When we make regulatory changes that increase compliance costs, bureaucratic red tape, and taxes without the promise of lower health insurance premiums, there is going to be a splintering of support by those paying the majority of the tab. Without a rethinking of some of these proposed changes, it will be very difficult or impossible for the local employer community to continue to urge a wait and see policy.

Jon Hurst