A large health plan is privately expressing concern that a little-noticed provision in the Senate health bill could drive up premiums for small business health plans.
The Better Care Reconciliation Act, one health insurance industry source warned in a private email obtained by Vox, would "cause most small employers' premiums to go up" and "leave consumers at risk."
No health insurance plan has so far spoken publicly about this specific concern. The industry has so far been muted in its criticism of the Republican health care repeal efforts but, as this email shows, some are privately worried about its consequences.
The section of the law in question is one that, so far, has gotten little attention. The language is complex, but multiple experts who have reviewed the section believe it would reverse key consumer protections in small business health plans — including the requirement to cover essential health benefits — and take away regulatory power from the states, and potentially push up costs for small businesses whose workers are not overwhelmingly young and healthy.
"The problem is that it removes the states' capacity to protect consumers in their states," says one former state insurance commissioner, who asked for anonymity to speak openly about Senate bill.
Experts worry that this re-regulating of the small business market could disadvantage sick Americans. Small businesses with healthy employees may join associations that sign up for plans with fewer benefits and lower premiums, pushing down their employees' premiums.
Small companies that have employees with expensive health needs, however, may get stuck purchasing increasingly expensive plans.
"I think it's pretty clear that this would allow market segmentation," says Timothy Jost, an emeritus professor at Washington and Lee University. "There are certainly winners and losers."