Small-business attitudes vary concerning insurance exchanges

NEW YORK-A recent statewide survey revealed that a majority of New York State's small business owners support health exchanges as a way to provide insurance to their employees, but will other state exchanges receive a similar response? According to industry experts, it's hard to say.

"I think the survey is very useful in understanding how it might be received by small businesses," says Vincent C. Ashton, president and CEO of HealthPass New York, the health exchange that commissioned the survey, "but I don't know that it will take the place of each state trying to get that direct sense of what their small businesses are looking for in a small business SHOP exchange, in order to make it a viable solution for them and their employees."

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"There are a lot of entities and advocacy organizations, state officials and people who have been putting together [the Patient Protection and Affordable Care Act] in the first place, who all have theories about how this might work and how it will be received," Ashton says. "But I don't know that we had seen people actually reaching out directly to those who are going to be affected."

Out of 300 participating small business owners, each with 50 employees or fewer, 84% thought health insurance exchanges were a good idea. The survey also showed that while many small businesses are struggling, there is significant potential for modifying New York's healthcare marketplace with exchanges.

For example, only 27% of the small business owners reported that their own businesses are doing well, but 50% agree that if they didn't spend so much time dealing with their employees' healthcare, they could spend more time thinking about how to grow their business. Additionally, 76% said they would consider using an exchange when enrolling their employees in a health benefits program, and 60% that do not currently provide health insurance to their employees said they would be more likely to offer coverage if an exchange was available.

Ashton says that employers have some trepidation about the economy, and with healthcare in general, but it's pretty clear from the statistics that they are looking to start reining in some of the costs associated with healthcare. That said, there's no way to be certain that the thoughts of New York business owners will be the same as business owners in other insurance markets.

"It's not something that easily translates over state lines because of the differences in rules and regulations," says Ashton.

He says exchanges will establish a new marketplace with growth potential and the ability to attack the underlying costs of medical care, "which is really the main driver of what the problems with the cost of healthcare is in general."