In the new world of the Affordable Care Act, Republicans say a bill that reduces the ability of some Ohioans to retain employer-based health insurance will be a benefit as they access less-expensive options on the open market.
But some Democrats and advocates for the poor remain skeptical.
The Ohio House is expected to vote in May on the business-backed House Bill 511. It would reduce the time Ohio allows some young adults to stay on their parents’ health insurance, eliminate “ mini-COBRA” insurance for some who lose their jobs, and raise the trigger-point for when small companies must offer health benefits.
“I get that if you read this holistically you go, ‘You’re taking away coverage,’" said Rep. Barbara Sears, R-Sylvania, the bill sponsor. “But when you really apply it to how it actually works, we’re actually giving people more options because we’re freeing up the potential for getting on the exchange.”
Sears and other supporters say that when state law gives people access to employer health insurance, or insurance through a parent’s plan, they cannot qualify for potentially less-expensive insurance on the federal exchange.
But Rep. John Patrick Carney, D-Columbus, questions that assertion. The federal government sets a floor of benefits, he said, and while the state can enhance those benefits, it can’t detract from them in a way that keeps people off the exchange.
“There could be an argument that federal law has created this problem and there needs to be an adjustment,” Carney said. “But I’m not buying that it’s this state law that is somehow creating this problem for these individuals.”
The bill seeks to align Ohio law with the Affordable Care Act, which allows dependents to remain on parents’ health insurance to age 26. Current Ohio law, which generally affects smaller and mid-sized companies, sets it at age 28.
Col Owens, senior attorney for the Legal Aid Society of Southwest Ohio, said Ohio raised the bar to age 28 in 2009 as officials here and in about three dozen other states recognized the difficulty young adults were having in obtaining employment with health benefits.
“Even if only a modest portion of these young adults would benefit from retaining the state law, it still remains sound public policy, as it was in 2009,” he told lawmakers.
The problem, Sears said, is they don’t benefit anymore. She said health plans no longer just add on a 27-year-old to a parent’s plan as another dependent, but rather charge for a separate single plan that averages $350 a month.
“I’ve talked with probably 60 different insurance folks, and I have yet to find one of them who has said it is cheaper to do a 26- or 27-year-old on mom and dad’s policy than it is to do it on the open market,” said Sears, an insurance-industry veteran. “There was a time when that wasn’t true … because there weren’t that many options out there.”
The bill also would align Ohio law with the Affordable Care Act requirement that employers with at least 100 workers offer health insurance to those who work at least 30 hours a week. Ohio law sets it at 25 hours for businesses employing two to 50 workers.
“A mom-and-pop pizza place has a greater duty to cover employees than (Procter & Gamble), Honda or Timken,” said Richard Mason of the Ohio Restaurant Association.
The different standards, Sears said, “just add one more layer of confusion.” But critics argue it could let employers continue to offer health benefits even if worker hours are reduced below 30.
The bill also eliminates what’s known as Ohio’s “mini-COBRA” requirement that businesses with 20 or fewer employees offer terminated workers continued coverage at 100 percent of the employer’s cost.
Kevin Conrad of the Ohio Association of Health Underwriters told lawmakers that, as people can no longer be denied insurance because of a pre-existing condition, and a terminated worker can seek subsidized coverage in the federal marketplace, the law “is no longer relevant.”
Owens argued that a worker who loses his or her job could face a break in coverage while seeking new insurance in the marketplace, and others note that the new policy might not be as generous.
“I suppose I could find a person who wants to pay a higher premium for that specific plan,” Sears said. “But I can find you hundreds that are going to want to get into the exchange.”
By Jim Siegel - The Columbus Dispatch, Ohio (MCT)
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