Bill would allow small businesses into Missouri Consolidated

Friday, December 18, 2009 | 12:01 a.m. CST

JEFFERSON CITY — With federal health care legislation lingering in Washington, there have been multiple bills pre-filed for the 2010 Missouri legislative session dealing with health care.

Among them is a bill that would allow small businesses to join the same health insurance pool as state and local government workers — the Missouri Consolidated Health Care Plan.

Missouri Consolidated provides health care to more than 107,000 state and local government employees. The idea to add various groups to the plan has been proposed in the past.Bill sponsor Rep. Sam Komo, D-House Springs, said that with the national health care bill in limbo, there's no point in waiting.

"Until the president has something on his desk, we don't know if we're going to have a bill or what would be in that bill," Komo said. "We can't sit on our hands waiting for what they do."

Komo said the goal of his bill is to provide an affordable solution for small businesses — such as those owned by his father — that want to provide insurance to their employees but can't afford it.

"My dad would love to insure his employees, but he can't afford going into the open market with his 10 employees and get a fair shake," Komo said.

Under the legislation, any business with fewer than 50 employees could join Missouri Consolidated. It's unclear how many people would qualify to join the program overall under the bill.

But other state representatives said that although the measure might sound like a good idea, it will be costly to the state.

"The people of Missouri pay quite a bit for health care given to state workers, so it's a burden on the taxpayer," said Rep. Rob Schaaf, R-St. Joseph, a doctor and committee chair of the Healthcare Transformation Committee. "Anything to have taxpayers further subsidize subsets of businesses might overburden them."

Rep. Doug Ervin, R-Holt, said there is no reason for taxpayers to be subsidizing health care for businesses when they can buy private insurance for the same price without a state contribution.

"People file these bills out of ignorance," Ervin said. "They don't know what it actually costs. They say I'm only paying $46 while the state's paying $451."

The numbers Ervin cited are those for an individual plan. For a family, the cost is $311 for the employee and $1,236 to the state.

"You can get a plan on the private market for that cost, without the contribution from the state," Ervin said. 

There are also questions about how adding more people into Missouri Consolidated's bargaining pool will affect prices.

"Next year, rates are going to go up, people are going to drop it and the only people who are going to stay with it are the sick ones," Ervin said. He added that only those who cannot get health insurance elsewhere will stay in the insurance pool.

Others see that as an unlikely scenario.

"Oftentimes you have an adverse pool because only sick people come in, but with small businesses you have a large pool, and combined with the state that has healthy workers, I don't think it would be a negative," said Rep. Mary Still, D-Columbia. "You avoid the adverse selection process that normally crops up."

Komo said now is the time to act.

"Somehow we've got to do something for these small businesses," he said. "With the economy, it was important before, but especially now that people are struggling to keep their employees on, giving them insurance is another struggle."

Sen. Joan Bray, D-St. Louis County, sponsored a nearly identical measure in the Missouri Senate.

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Marilyn Zemp December 18, 2009 | 10:41 a.m.

I am single, older woman 63 in good health, not on any meds and in the process of starting a small business. I have an individual plan with a high deductible. Between the premiums and the deductible I will have to pay nearly $8,000 before I see any return. I am glad I can get health insurance but the cost is horrible especially for someone in good health. And then when I consider growing my business I just shake my head and say no way. I have pretty much decided to do as much as I can by myself and keep it small.
The business I want to start is a doll that I created and I would like to have women in their homes help me with it when it gets to the point I can't keep up with the demand. I don't want to send it overseas to China. The cost of hiring someone and the taxes involved, the rules about independent contractors and then healthcare costs is overwhelming.

Plus the way healthcare costs are figured seems backwards.
I don't understand why I can't be put into large group period rather than in a individual pool. The large pool always wins and the individual loses when in come to premiums.

When I go into McDonald's and buy a burger it costs 3.99 as an individual, if go in a group of 20 it still costs 3.99.
Several years ago I had a individual policy and wanted to get a mammogram. I called on one of the hospitals here and they wanted $300 for a facility fee. Crazy.
Where is information on cost analysis on how much a hospital charges a particular procedure. There seems to be no information regarding comparisons. It's one price for one group and another price another group. I want to know what it costs them bottom line and who is being most cost effective and giving me the best value for the dollar.
I am not saying I want government regulation but I would like to have some public information on who is doing the best job to contain costs. No wonder the cost of medical care is going up. It is hard just to figure out a statment. Another example is when I went in for annual checkup and had some tests done I was shocked to see who got a piece of the pie. Everyone is a specialist.
There were charges for using the office because they rented the space, charges for the lab tech, charges for lab work, charges for each of the doctors who read the results of the pap smear and lab tests. In the olden days I would have gone to the doctor and paid for the office visit and lab costs. I was totally amazed at the amount of paperwork and bills I received for a basic annual checkup.

I know I am rambling here. But I really would like to know if there is an organization that deals with healthcare and
cost effectiveness. The way things are set up now costs for medical care are going to keep going up because no one seems to able know what it really costs or where the money goes. Are we talking about $25 for a bandaid some day and if so, why?

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