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Health Care Reform for Small Businesses

The number one key to success for small businesses in the state’s Health Benefit Exchange is choice, according to several presenters at a panel discussion last week in Sacramento.

“You have to have choice, that’s the big thing,” Bill Wehrle of Kaiser Permanente said. “If you don’t have choice, people won’t sign up.”

Wehrle was part of a forum addressing the needs of small businesses in California, and what the state’s exchange needs to do to woo both small-business owners and their employees.

Terry Gardiner of the Small Business Majority said his organization did some extensive research on what has worked and what hasn’t worked in previous exchange-like efforts.

“One of our big conclusions is having employer choice and employee choice is what’s needed above all else,” Gardiner said. “Because you’re trying to get people to change, and they need a better choice.”

Gardiner added that it can be tempting for an exchange to offer too many choices and for the state to require too many coverage mandates. “The exchange needs to stay lean and mean,” Gardiner said. “You can’t layer on extra cost and expect people to be able to afford it.”

Health insurance brokers can be an important and overlooked resource for an exchange, Gardiner said, and can be especially helpful for small businesses. “The exchange has to reach out to them,” he said, “to make sure the website has a good portal entry for the brokers.”

Panel moderator Micah Weinberg of the Bay Area Council talked about how intricate and difficult it can be to analyze the future workings of an entity the size of the Health Benefit Exchange.

“Dig into the details of any business and it’s complicated,” Weinberg said. In a complex environment, he asked, “How does a small group exchange win?”

Shawn Nowicki, health policy director of HealthPass New York, had a two-word answer:

“Administrative help,” Nowicki said. “Whether you’re looking at a hedge fund operator in Manhattan or at Bruno’s Auto Body on the outskirts of Brooklyn, these people are not in business to deal with health insurance and be experts on health insurance plans.”

However the state’s exchange is structured, Gardiner said it will need to adapt and be flexible.

“A lot more choices means evolution,” Gardiner said. “You need to figure out, what are the feedback mechanisms you have, so they can evolve. Obviously the exchange needs to have that [feedback] interaction with health plans, but the same thing has to happen with employees and brokers. The exchange is a new thing, and it will evolve. It needs to evolve.”

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