What Small Businesses Need to Know about Health Care Reform

By Mary Tablante

Health care reform is intended to provide everyone with affordable access to health insurance. But for small businesses, providing health care can be a challenge because of numerous factors, including the increasing cost of health insurance premiums.

To help ease worries for small businesses the Obama Administration delayed an employer mandate until 2015. The mandate will require businesses with 50 or more employees to provide health insurance for their workers.

The mandate was supposed to go into effect Jan. 1, 2014. If a company with 50 or more employees does not offer insurance by the new 2015 deadline, they will face a fine of up to $3,000 per employee.

Thomas Schmidt, nurse manager of inpatient psychiatry at Johns Hopkins Medicine, said a small business owner might struggle to afford health care while maintaining staff salaries. The high cost of providing health care is another obstacle employers and employees face in obtaining health insurance.

“Small businesses find it hard to be able to afford health care packages for their workers; (it’s) harder and harder to have full time workers,” Schmidt said. “More and more businesses want part time (employees).”

This year, the Asian Pacific Islander American Health Forum (APIAHF) conducted a study about Asian American, Native Hawaiian and Pacific Islander-owned small businesses and health reform throughout California to find out about the challenges small businesses face to obtain health insurance and what they know and didn’t know about the Affordable Care Act.

In addition, small business owners often don’t know how or where to get information about providing health insurance, or face language and cultural barriers, according to the study.

Iyan John, senior policy analyst at the APIAHF, said one of the benefits of the Affordable Care Act is that small businesses can get the advantage of tax credits if they provide insurance to their employees and that not many people were aware of these tax credits.

Business owners want to know whether or not the tax credits are going to offset the cost of providing health insurance to their employees; they want to know specific dollar values, John said.

“A lot of people have known about the (Affordable Care Act), but don’t know the provisions and incentives,” he said. “They’ve heard of it, but there’s a lot of misconceptions. A lot thought that all required to provide insurance to their employees which is not the case … 50 or less (employees) is not mandated.”

On the APIAHF website, a testimony from a small business owner, Kijoong Shin, reads, “Before health care reform, I was on Nationwide insurance with a $5,000 deductible. I had open-heart surgery and the bill was $54,000. The insurance company cancelled my policy because my bills were too high. I had to self-pay for all follow up doctors’ visits, other lab and x-rays, and medicine. In 2008, my business went under and I could not afford insurance. I have been uninsured ever since. Health care reform is important to me because I was unable to afford insurance and now I can get health insurance.”

Schmidt said the fact that lawmakers are addressing how to make the system work for the majority of the citizens is a step in the right direction.

“I’m cautiously optimistic that, as a health care professional, the system needs great change,” he said. “It’s hard to say if this is the best change. Any transition is going to be difficult and painful, and it’s easy to put the blame on a misguided target as to where the cost of health care is, so it’s really a challenge and a vexing question.”

Schmidt added that one of the things health care doesn’t address is medication shortage and that mental health benefits are poorly covered by insurance.

Nadine Gracia, director of the Office of Minority Health at the U.S. Department of Health and Human Services, posted information about health care on the White House Initiative on Asian Americans and Pacific Islanders website on July 10.

Gracia wrote that almost one out of every five AAPIs lacks health insurance and explained how the health care law allows AAPIs to gain greater health coverage access, “allows young adults to stay on their parents’ health insurance plan until age 26 and prohibits insurance companies from denying coverage to children because of a pre-existing condition, like diabetes.”

Her post also explained the Health Insurance Marketplace, a new initiative that will help provide nearly two million uninsured AAPIs new opportunities for coverage.

John said there will also be more funding to community health centers in order for AAPIs to receive information in several languages, including Bengali, Chinese, Hindi, Korean, Tagalog and Vietnamese.

The Health Insurance Marketplace allows small businesses, individuals and families to search for health coverage options and apply to enroll in a plan that is the best suited for them. Businesses and individuals can compare plans based on price and benefits, and it will help them find out if they eligible for assistance to help pay for premiums or other programs like Medicaid, Gracia wrote.

Enrollment in the marketplace will start on Oct. 1 for health care coverage beginning in or after January 2014.

Call toll-free at 1-800-318-259 to speak with a representative. The call center offers assistance 24/7 in more than 150 languages.

More information can be found at marketplace.cms.gov and the White House Initiative on AAPIs website, www.whitehouse.gov/aapi.