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Most small business executives support measures currently before Congress to protect patients and regulate managed care even if premium costs rise as a result. While many report that they would absorb those costs, an equal number would pass some or all of the costs on to their employees.
These were the findings of a national survey of 800 small business leaders recently conducted by the Kaiser-Harvard Program on the Public and Health/Social Policy, in conjunction with the American Small Business Alliance Education Fund.
Almost three-fourths of executives surveyed said their companies provide health insurance to at least some of their full-time employees, and 55 percent offer it to all.
The vast majority of the businesses indicated they would maintain coverage if their share of premiums for an individual policy increased by either $1 to $5 or $15 to $20 a month as a result of consumer protection legislation, a range reflecting high and low cost estimates. About 45 percent to 50 percent would absorb all costs, but many would pass costs along: 33 percent to 35 percent would absorb some, about 8 percent to 9 percent would pass all increases on to employees, and about 1 percent to 3 percent would drop coverage, depending on the size of the increase.
About 33 percent said they expect the proposals to cause health insurance premiums to increase "a lot."
When asked how they felt about the key provisions of the leading consumer protection proposals, without being presented with arguments for or against them, the executives registered strong support, with the strongest going to measures requiring health plans to provide additional information on how they operate (89 percent favored; 5 percent opposed) and allowing appeals of health plan decisions (88 percent favored; 8 percent opposed). Allowing patients to sue their health plan was favored the least, but still garnered majority support (61 percent favored, 30 percent opposed).
Support fell, but still outweighed opposition, if small business heads heard that regulation might cause premiums to rise. If they heard that regulation might result in government's becoming "too involved" in health care, however, their support decreased significantly. When presented with this argument, for example, only 44 percent still favored requiring that all patients have the ability to appeal health plan decisions, while 42 percent were opposed. Forty-one percent favored requiring direct access to specialists, and 50 percent were opposed. As for allowing patients to sue their health plans, 33 percent were in favor while 54 percent were opposed.
Not surprisingly, small business leaders overwhelmingly want standards to be developed and enforced by a nongovernmental, independent organization (62 percent). Yet, despite their concern about government involvement, more executives favor consumer protections to ensure people get the "care they need" than oppose them as "unnecessary government involvement."
"These findings challenge traditional assumptions made about the small business community; in fact, today's small businesses do care about quality health care, and believe it is worth paying for," said Joel Marks, executive director of the Washington, D.C.-based American Small Business Alliance Education Fund.
The survey is available by calling the Kaiser Family Foundation's publication request line at (800) 656-4533 and asking for document 1403, "The National Survey of Small Business Executives on Health Care." Related information can also be found on the foundation's Web site at www.kff.org.