A recent Forbes.com blog post by Josh Archambault noted that the national Affordable Care Act will have a disproportionately negative impact on Massachusetts small business, due in large part to the fact that the state already has Universal Health Care. According to Archambault, Massachusetts officials now predict “extreme premium increases” for many small businesses.
Of course, these same small businesses and their employees are already bearing more cost than their fair share since the Bay State has already dumped sicker individuals into the same risk pool as the healthier employees of small business.
In a real shock to ACA supporters, the Boston Globe backed away from its full-throated backing of Obamacare and opined that Massachusetts deserves special treatment – and a waiver – because they’re leading the way on cost containment.
According to Achambault, the problem is far worse than the Globe editorial admits:
The incentives to self-insure under the ACA will be even greater for companies with 50-100 FTEs that have a relatively healthy workforce. These companies can self-insure and be exempt from all state, and some, federal mandates. This will result in an even sicker population being left in the small group marketplace, and higher premiums as a result.
When the healthier small business employees subsidizing coverage for higher-risk insureds are pulled out of the pool as their companies opt for self insurance, there is a far, far greater risk the the Administration’s online healthcare marketplaces will collapse. This would set Obamacare adrift, fall heavily on small business and very likely cause a severe national health care crisis.
And, as the more expensive, complex and invasive tenets of Obamacare start to roll out – because, by design, we’ve only seen the least damaging portions so far – this can only get much worse.