Health Care Policy

Health Care

Manage Costs and Empower Employers

Rising costs in health care have led health insurance to represent a growing burden for employers. Small businesses report year-over-year double-digit increases in health insurance costs for their employees. While the trend of rising health care prices has been a persisting obstacle for over 20 years, small businesses are reaching a breaking point. Entrepreneurs are increasingly reporting that they’ve had to reduce benefits, shift a higher percentage of premiums to their employees, or eliminate benefits altogether. In particular, sole proprietors and independent contractors often find themselves priced out of the market completely.

Small businesses want to offer top-of-market benefits to their employees. In today’s competitive labor market, a quality health care package is essential to attract and retain excellent employees. Despite their commitment, small employers are increasingly unable to sustain these benefits due to skyrocketing costs. Small businesses account for roughly half of the private sector jobs in Michigan, and these employees and their families deserve access to affordable health care options. SBAM supports policy solutions that lead to lower costs through limiting mandates and fostering an open, transparent, and competitive market.

Health Care Policy Task Force Report

Flexibility

Flexibility is a competitive advantage for small businesses, and that should extend to how they can offer benefits.

Health coverage decisions should be negotiated between employers and employees, without unnecessary interference.

One-size fits all mandates that require certain types of coverage or administrative processes should be avoided.

Expand Access Through Innovative Tools

SBAM supports policy solutions that expand access to quality care and level the playing field for small businesses, including:

A state-level catastrophic insurance pool can help lower premiums and deductibles in the individual and small group markets, particularly for those who do not qualify for subsidies.

Association Health Plans (AHPs) allow small businesses greater flexibility to band together to form risk pools, which gives them the same level of flexibility currently enjoyed by large companies.

Transparency & Accountability

In today’s health care market, it is increasingly difficult for consumers to understand what they are paying for. As costs increase, it’s more important than ever that purchasers understand their bill.

Health care pricing should be transparent, including pharmaceutical costs and in the PBM market.

Transparency requirements should expose conflicts of interest that result from vertical and horizontal integration.

It is vital that health care consumers are educated to be better health care shoppers through simplified tools that allow for accurate price comparisons.

Limit Mandates

Health care is and will remain a heavily regulated industry, but some mandates can drive costs and disproportionately affect small businesses.

Policymakers should avoid mandates that increase costs without improving outcomes, and mandates that shift costs to small employers.

Competition

Vertical integration and market consolidation have presented barriers to both transparency and competition by introducing conflicts of interest and potential for price hikes.

Customers must retain access to a competitive marketplace when hospitals own health plans, when health systems merge, when private equity firms consolidate specialty practices, and when health systems buy physician practices.

SBAM supports patent reform and use of biosimilars as tools to stem suppression of competition in pharmaceuticals.