The government passes a byzantine 906-page law that touches almost every American citizen and business. Opponents wage a three-year war trying to undo it. No surprise, then, that the public ends up bewildered. That includes business owners who have real-money decisions to make about health care next year—and apparently don’t grasp the most basic elements of the health reform law.
A majority of business owners with fewer than 50 employees believe they have to provide health insurance to workers next year or pay a fine, according to a new survey by online health insurance marketplace EHealth (EHTH). That, of course, is wrong. The Affordable Care Act’s employer mandate, which takes effect in 2014, only applies to businesses with more than 50 people working at least 30 hours a week (or an equivalent number of part-timers).
EHealth’s February online survey polled 259 business owners who had purchased health policies through the website. All reported having fewer than 50 workers, and 95 percent had 10 or less, meaning they’re nowhere near hitting the mandate’s threshold. Still, 56 percent of respondents incorrectly thought they would be subject to the mandate.
“I think chaos is not too strong of a word to describe what’s going on in this market,” says Robert Hurley, EHealth’s senior vice president for sales and operations.
Confusion abounds on the consumer side, too. After the Supreme Court upheld the bulk of the law last summer, a Pew Poll found that only 55 percent of respondents understood the decision, even though 76 percent had strong opinions about it.
Jeff Bevis, chief executive officer of FirstLight HomeCare, told me recently that some workers in his senior care franchise system expect the law to deliver free health insurance. His company is working to design health plans that will be affordable to the system’s 900-plus employees. But under the law, “affordable” premiums can cost up to 9.5 percent of workers’ income. “The continuing question keeps coming up: ‘Well, when do I get my free health care?’” Bevis says. “There’s a disconnect. People really don’t think they have to pay anything.”
Let’s face it: Health policy is boring and complicated. No surprise most people tune out. But if small businesses are as poorly informed as the EHealth survey suggests, there’s going to be a steep learning curve as the biggest pieces of Obamacare take effect in the next year.