Floridians working for small businesses pay more out-of-pocket for health insurance than their peers employed at large companies, according to a report from the Commonwealth Fund.
The report from the independent healthcare research firm calculates that small business employees pay $2,235 more in deductibles for family plans than people working in companies with more than 50 employees.
Although the discrepancy dents people’s wallets in all but three states, Florida ranks 19th with the highest deductible for family plans offered by small businesses in 2023, costing $5,813 annually.
Even people without dependents at small companies faced deductibles around $500 higher than their counterparts at large businesses, the Commonwealth Fund found.
Generally, people working at large companies get better coverage for a smaller portion of their paycheck, the report shows.
“[Small employers] just don’t have the leverage that a large employer does, their administrative costs are a little higher and, when they offer it, they may not offer as generous a plan, so you end up with people paying a little more in coverage that’s maybe not as good as if they were working for a large employer,” Sara Collins, one of the report’s authors, said in a phone interview with Florida Phoenix.
For family plans, small business employees pay 32% of the premium compared to 30% at larger companies. For single coverage, the rates are 21% and 17%, respectively.
Who gets coverage through small businesses?
Nearly every (99.8%) business in Florida has fewer than 50 employees, and 3.4 million Floridians worked for a small business in 2023, according to a report from the Office of Advocacy at the Small Business Administration. However, 2022 data from the Florida Health Insurance Advisory Board showed 420,276 people received coverage from a small insurance group.
The Affordable Care Act aimed to increase access to affordable health insurance by expanding Medicaid, a safety net health care program, to people who earn 138% or less of the federal poverty level, or $20,783 annually for an adult. People earning more than that, but less than 400% of the federal poverty level, or $60,240 annually for an individual, qualify for subsidized health insurance plans sold in the ACA “Marketplace.”
Because the Republican-led Florida Legislature has refused to expand Medicaid, as allowable under the ACA, Medicaid enrollment in Florida is limited to adults with children whose household income is less than 28% of the poverty level, or less than $7,230 annually for a family of three.
Adults without dependent children don’t qualify unless they’re low-income and have a disability.
The decision to reject Medicaid expansion has left an estimated 315,000 Floridians in the “coverage gap,” according to the Center on Budget and Policy. That means they earn too much to qualify for traditional Medicaid and too little to qualify for a tax-subsidized health insurance policy through the marketplace.
Will the federal government create another option?
“Congress could fix this and make it possible for those people to get covered either through the Marketplace plans or some other similar insurance program that maybe looks more like Medicaid,” Collins said.
But the likelihood of that happening under a Trump administration is slim since the president-elect unsuccessfully attempted to repeal the ACA during his first term. He has said he plans another attempt to repeal the federal law, often referred to as Obamacare, during his second term.
A month into open enrollment through the Marketplace, 1.4 million Floridians have enrolled in the ACA, according to data from the Centers for Medicare and Medicaid Services.
Scott Darius, executive director of Florida Voices for Health, said the report shows how the system can be strenuous for small employers and their employees.
“A lot of the time, you have jobs that don’t offer health insurance in the first place. So, if you’re lucky enough to find one, and now you’re facing this additional burden of paying more of that share, it becomes a lot,” he said in a phone interview with Florida Phoenix.
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This article originally appeared here and was republished with permission.
