Small Business Health Insurance Problem
Sunday, December 5th, 2010The data offer three key takeaways for policymakers. First, only a minority of new businesses offer health insurance to employees, even by age five. Fewer still move from not offering insurance to providing it. When thinking about how to manage small business health insurance, policymakers need to keep in mind that offering insurance isn’t something that young companies naturally evolve to do as they mature. Consequently, most of the employees at new businesses that don’t offer health insurance will need to be covered by government programs and state exchanges.
Second, new companies that don’t offer insurance tend to be smaller, lower-paying, sole proprietorships with a large share of part-time workers. These offer employees limited benefits. Policy makers need to recognize that offering employee health insurance is something that fits certain kinds of new companies and not others. Small business owners who don’t offer employee health insurance aren’t being heartless. They are responding to the economics of the industries they are in and the business models they are pursuing.
Third, offering employee health insurance doesn’t improve the financial performance of new companies. Policymakers need to understand that despite the many reasons why they want the founders of all businesses to offer health insurance to employees, requiring that entrepreneurs provide such insurance won’t benefit many of the business owners.
Hundreds of thousands of new businesses with employees are founded in the U.S. every year. Few of these companies are large enough, pay enough, or are structured in a way that would lead them to offer employee health insurance. Moreover, few will turn into businesses that provide health care coverage to their workers. As a consequence, most of the several million workers hired by young businesses annually will be getting their insurance from government programs and state exchanges for years to come.
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