Affordability of health insurance to small business: implications of the patient protection and affordable care act.

摘要

Due to rising costs there has been a substantial decline in employer-based health insurance coverage, especially in the small-group market.1 Between 1999 and 2009, premiums paid by small- to medium-sized employers (3 to 199 workers) increased by 123 percent; at the same time, the proportion offering coverage declined from 65 percent to 59 percent (Kaiser Family Foundation/HRET 2009). Among very small businesses (three to nine employees), just 46 percent now offer coverage, compared with 56 percent ten years earlier. The rate of decline has been especially pronounced in low-wage firms, where the proportion of businesses with fewer than ten employees and more than half of workers making at or below the twenty-fifth percentile in hourly wages fell from 24.4 percent to 18.4 percent between 2000 and 2008 (Blumberg and McMorrow 2009). Compared to just a little over one-quarter of workers in larger firms, more than half of workers in firms with fifty or fewer employees were uninsured or underinsured in 2007 (Collins et al. 2010).