Analysts at the Commonwealth Fund are arguing that individual and small group market provisions in the Patient Protection and Affordable Care Act of 2010 (PPACA) could be especially helpful to low-income workers at small employers.
Ruth Robertson and other analysts at the think tank, which published reports that helped shape the law, talk about the problems workers at small employers face in a commentary on how PPACA could help those workers.
Robertson and her colleagues write in the report that fewer than half of workers at employers with fewer than 50 employees were eligible for health benefits in 2010, down from 58 percent in 2003.
The analysts note that 90 percent of workers at large employers are still eligible for health benefits.
Only 33 percent of workers at small employers actually got health benefits from their employers in 2010, compared with 71 percent of the workers at employers with 100 or more workers, the analysts said.
Just 18 percent of workers at small employers who earn less than $15 per hour get health benefits from their employers, the analysts said.
Because of a combination of low wages and lack of benefits, 54 percent of low-wage workers at small employers reported having cost-related problems with getting health care. About 28 percent of the high-wage workers at large employers had cost-related health care access problems.
The analysts said the PPACA small business tax credit, small business health insurance exchange, individual health insurance exchange, individual sales rule and Medicaid expansion provisions should help.
PPACA “will improve the affordability and comprehensiveness of coverage for both small businesses who want to offer coverage and for workers in small businesses who are not offered and eligible for coverage through their jobs,” the analysts said.
The analysts do not discuss other factors that health insurance brokers have suggested may affect the affordability of state health insurance mandates, such as state health insurance mandates and increases in the underlying cost of health care.