Providing employees with health coverage is a struggle for
Carrie Howard, co-owner of DJ's Industrial Rubber Products, a six-employee
Oklahoma City company that sells fire-hose fittings. Even with 2005
sales at $1 million, the company can't afford to cover its
employees. Howard says, "If they could have a $20 co-pay, or
any help with prescriptions, they would do it."
Howard, 42, and the company's employees could get help very
soon from the state government. In November, Oklahoma started
Oklahoma Employer/Employee Partnership for Insurance Coverage, a
voter-approved statewide health insurance program for companies
with fewer than 25 employees. Funded largely through a tobacco tax
increase, the state picks up 60 percent of an employee's
premium, the employer pays 25 percent, and the employee pays the
remaining 15 percent.
The program will help Oklahoma's small employers provide
benefits and reduce the number of Oklahoma's
uninsured--currently 600,000. Within the first few weeks of the
program, 206 companies had submitted applications, and its mailing
list has ballooned to 4,500 subscribers. "We've had a ton
of phone calls," says Matt Lucas, project director for the
Oklahoma Health Care Authority, which is administering the
employer/employee partnership. "It's a fairly innovative
program."
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Oklahoma isn't alone. An October 2005 study by the Kaiser
Family Foundation on Medicaid and the Uninsured found 20 states
have increased access to health-care options. Illinois' new All
Kids plan will provide affordable health-care coverage to uninsured
children of working parents. The Massachusetts legislature,
meanwhile, is debating whether to require residents to carry
health-care coverage via an employer, the government or a
self-funded policy, with low-income individuals qualifying for a
subsidy, and potential tax breaks for employers who provide health
insurance.
"States are all over the map in terms of what they're
doing," says John E. McDonough, executive director of Health
Care For All, a Boston group advocating accessible and affordable
health care for all Massachusetts residents. "Some states are
looking at creative ways to help small employers."
State budgets are moving back into the black, and that's
allowing them to pump money into once-dormant initiatives. In 2005,
45 states exceeded budget projections, and the other five met their
targets, according to a recent report on states' fiscal health
by the National Association of State Budget Officers. Compare this
to 2003, when 37 states slashed spending halfway through their
annual budget cycles.
"I don't think [states'] interest in this issue
ever went away," says Alan R. Weil, executive director of the
National Academy for State Health Policy, a Portland, Maine,
nonprofit that analyzes state health-care policy and practices,
"but a sense of not having the resources to do anything about
it [put progress] on hold."
Entrepreneurs struggling to pay for employee health coverage
have some new options, but they have to stay realistic: "The
resources available to help small businesses afford health coverage
are limited," Weil says. "But there are enough states
trying to figure out how to extend some help to small businesses
that it's a good idea to [look into] what's
happening." Your state's insurance department is one place
to start.
Paying attention paid off for Howard: She signed up for
Oklahoma's new program the day it started taking applications.
"I read [about] it in the paper a long time ago and just tried
to keep up on it," she says. At press time, Howard was
preparing to give employees insurance applications to fill out.
States still face their share of budgetary challenges; many
states are in debt from borrowing heavily during the downturn. And
demand for Medicaid continues to increase. The big question is how
long politicians will leave it to states to triage a nationwide
health-care crisis. "The only effective long-term solution
will be national," says McDonough. "And it's not a
real issue on the Washington, DC, radar at this point."