Trump's birth control rules go against wishes of small businesses

When the Trump administration recently finalized new rules that will allow some employers to opt out of providing their employees with access to birth control coverage, it didn’t just attack women’s rights, it also went against the wishes of most small businesses, which support providing contraceptive coverage in employer-sponsored health plans.

Allowing employers to opt out of birth control coverage gives them the opportunity to ignore a rule established by the Affordable Care Act (ACA), which states that employer-provided health insurance plans must include access to no copay contraceptives.

If enough employers opt out of this coverage, it could one day raise health-care costs for small employers like me who believe their employees should have access to birth control by creating an imbalance in the small group marketplace.

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As a small employer, I can tell you small-business owners were not clamoring for this change to the ACA. In fact, Small Business Majority’s scientific opinion polling of women entrepreneurs found 71 percent agreed that health insurance issuers should be required to include birth control coverage in their health plans. Instead, what we really want lawmakers do is to strengthen the marketplaces and bring down costs.

Sadly, the administration’s new rule on birth control is not unlike other measures it has taken to undermine the ACA in recent months, including a rule that will make it easier for insurance companies to sell health insurance across state lines through association health plans.

While this rule will likely make it easier for a few small businesses with younger and healthier employees to purchase health plans that might be cheaper in other states, the tradeoff is the small-group insurance market would split in two: one pool for businesses that want bare-bones plans and one for firms that need more comprehensive coverage.

This would eventually lead to major spikes in premiums — particularly for small businesses with older or sicker workers.

Additionally, the administration chipped away at the ACA by allowing the expansion of short-term insurance plans, which can now last up to 364 days and be renewed for up to three years. These plans do not have to comply with ACA requirements and cover almost nothing, including pre-existing conditions.

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Since the customers for short-term plans tend to be younger and/or healthier, if the plans become popular, it will create an unbalanced risk pool that disrupts the individual marketplaces and raises costs for everyone else who remains in those marketplaces. This includes small employers like me.

The Trump administration’s approach to health care is ultimately bad for my business because the ACA is the first legislation to make health care an affordable benefit we can offer our employees. In fact, thanks to federal income tax credits provided by the ACA, my business is able to cover 85 percent of the health insurance costs for eight of my 15 employees.

The ACA has been instrumental in stabilizing premiums in the small-group market, and for small business that don’t have group policies, the ACA allowed their employees to buy subsidized health insurance through the marketplaces.

These gains could easily be lost, however, if the Trump administration keeps chipping away at the foundations of the law. For the benefit of small businesses, we need to do all we can to strengthen the ACA.

Mike Roach is co-owner of Paloma Clothing in Portland, Ore., and a member of Small Business Majority’s Small Business Council.