Small Employer, Big Crisis: Health Insurance Affordability, Market Reforms, and Policy Challenges
A Policy Luncheon held on July 14, 2006

Facing double-digit or near double-digit growth in health insurance premiums, many small employers in Ohio and the nation have either eliminated health benefits or significantly increased cost-sharing among employees. About 73 percent of Ohio’s small firms (defined as 2 to 50 employees) offer health insurance coverage compared to 95 percent of Ohio firms with over 50 employees.  Just over 40 percent of Ohio’s working uninsured (approximately 225,000 Ohioans) work for a small employer.

On July 14, 2006, the Health Policy Institute of Ohio brought together policymakers and stakeholders in a policy luncheon entitled " Small Employer, Big Crisis: Health Insurance Affordability, Market Reforms, and Policy Challenges" to explore these statistics and the underlying challenges of the small group health insurance market, as well as to gain insight into potential policy options.

A panel of national experts was on hand to present the evidence, discuss possible policy options for lawmakers and policymakers, and engage in candid dialogue with the participants.

Expert panelists included:

• Paul Fronstin, Ph.D., Senior Research Associate with the Employee Benefit Research Institute and expert on trends in employment-based health benefits, consumer-driven health benefits, employment health benefits and taxation, and public opinion about health care.  Dr. Fronstin discussed current trends in employment-based coverage, the rise of consumer-directed health care, and the impact of rising health care costs on small businesses
  
  
• Len Nichols, Ph.D., Director of the Health Policy Program, New America Foundation, and a highly respected health care economist. Dr. Nichols was previously Chair of the Economics Department at Wellesley College and has been a consultant to the World Bank, the InterAmerican Development Bank, and the Pan American Health Organization.  Dr. Nichols discussed several policy options for reforming the small group health insurance market, including association health plans, small business health plans, and health savings accounts.  Dr. Nichols stated that the problems with the U.S. health care system – low value per dollar, uneven and low average quality, and inequitable access – will require more than just incremental solutions.  Dr. Nichols believes that there is a moral and economic case to be made for major reform premised on individual and shared responsibility and a culture of value..
  
  
• Katherine Swartz, Ph.D., Professor of Health Policy and Management at the Harvard School of Public Health and author of “Reinsuring Health: Why More Middle-Class People Are Uninsured and What Government Can Do.”  Dr. Swartz was the principal investigator for the evaluation of New York State’s Healthy New York program and is editor of Inquiry, a journal focusing on health care organization and financing.  Dr. Swartz discussed government-sponsored reinsurance as a promising vehicle to reduce premiums in the small group health insurance market and reduce the number of uninsured.  Dr. Swartz cautioned that reinsurance is not a panacea, but an important part of a policy package to increase availability of health insurance to employees of small businesses.