How will health reform affect small, medium and large size businesses? Linda Blumberg answers this question in this RWJ policy brief. Blumberg summarizes the legislation as follows:
“Small employers, those with fewer than 50 workers, will face no new requirements but will have new insurance options made available to them through the new health insurance exchanges. These new options have the potential to save money for small businesses that wish to offer insurance to employees.
Medium-size employers, those with 50 to 100 workers, will have access to these new coverage options as well, but may face some financial penalties if their modest income, full-time workers obtain federal subsidies due to a lack of affordable coverage available through the workplace. New coverage sold to small and medium-size groups will be subject to regulations that will make insurance more affordable to groups with higher than average health care needs. Healthier groups will share in these costs more than they do today.
The vast majority of large employers (more than 100 workers)…are the least likely to be significantly affected by health care reform. However, they may experience greater employee participation in their current insurance plans and will face penalties if their full-time workers obtain subsidized coverage through the exchanges.”
This spreadsheet summarizes how key provisions will affect each of these three types of businesses.
- Linda J. Blumberg “How Will the Patient Protection and Affordable Care Act Affect Small, Medium, and Large Businesses?” Timely Analysis of Immediate Health Policy Issues, Urban Institute and Robert Wood Johnson, August 2010.