Helping Main Street Businesses Offer Health Plans
The following opinion article, written by Women’s Business Development Council founder and CEO Fran Pastore, first appeared in the Hearst Connecticut Media newspapers. It is reposted here with permission.
The Women’s Business Development Council is a mission-driven, nonprofit organization dedicated to helping women in business thrive and reach their personal economic goals through entrepreneurship.
Our focus is Main Street businesses, small employers that invest time and talent in their local communities and are an essential part of the economic vitality of the towns and cities where they work and live.
Since our founding 25 years ago, we’ve helped more than 17,000 clients, supporting the launch of more than 12,750 businesses and the creation of over 27,500 jobs.
We’re committed to helping businesses obtain the tools and resources they need to compete and grow—and that includes the ability to provide employees with affordable, quality health plan coverage.
Businesses that employ 50 or fewer people are not required by law—as larger companies are—to offer employees health insurance. While there’s no mandate, no small business can expect to compete and succeed if it does not offer health benefits.
It’s not only a question of competing for talent (no small challenge amid the current labor shortage), but fostering a workplace culture that supports employee health and well-being and reflects Main Street values.
The problem? It’s become almost impossible for small businesses to find affordable, comprehensive health plan options.
What’s needed most are solutions. State lawmakers have such a solution in their hands now: House Bill 6710, which permits what are known as association health plans, allowing small businesses access to the same options larger companies enjoy by leveraging the economies of scale: banding together to gain negotiating power and savings.
Association health plans have already taken root in a number of other states, including Georgia, Ohio, MIssouri, Maine, and Washington. The Connecticut bill is modeled on legislation the Virginia legislature passed last year and is now being implemented there.
I am encouraged by the bipartisan support the bill has attracted in the legislature. It is also backed by more than three dozen business groups, trade associations, and nonprofit organizations, all trying to find a solution to one of the biggest headaches faced by their members.
And it addresses real issues and concerns that I share with our thousands of clients, particularly questions around value, quality, equity, and oversight.
Essential Health Benefits
For instance, will these plans cover the essential benefits mandated by the federal Affordable Care Act, including doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services, and dental services for children?
Connecticut also requires that health plans cover additional benefits such as breast and ovarian cancer screenings, mental health wellness, telehealth services, and urgent crisis center services. Where does the bill stand on those coverages?
Will those with preexisting conditions be denied coverage? Will these plans discriminate against people based on their health status? Are these plans fiscally sound? Who provides fiscal and regulatory oversight?
I was happy to hear state Representative Kerry Wood, the Democratic co-chair of the legislature’s Insurance and Real Estate Committee, emphasize that the legislation was drafted by a bipartisan group, “making sure that we put the values important to us in Connecticut of ACA standards, including pre-existing condition protections, into this bill.”
Her comments are reflected in the bill’s language. Association health plans are subject to numerous state and federal laws, including the ACA, Health Insurance Portability and Accountability Act, the Civil Rights Act, the Women’s Health and Cancer Rights Act, the Public Health Service Act, the Mental Health Parity and Addiction Equity Act, and the Genetic Information Nondiscrimination Act.
These plans must cover ACA essential benefits and Connecticut-mandated benefits. Coverage cannot be denied because of a preexisting condition. Those who get sick will not lose coverage or face stiff premium increases.
That bill gives the Connecticut Insurance Department broad regulatory oversight of association health plans, including establishing and enforcing financial and solvency requirements, licensing and actuarial standards, and transparency and reporting.
Plans will be required to direct most of their premium revenues to medical care, with only a small percentage reserved for administrative costs.
In short, the bill offers real hope for Connecticut’s 360,000-plus small businesses and the more than 741,000 people they employ. It creates options that they do not enjoy today.
We’re dedicated to helping women in business reach their economic goals.
I hope that our state lawmakers will show the same dedication by supporting a meaningful, tangible solution to a problem that is a major obstacle for all Connecticut small businesses.
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