Associated Press
Published: May 10, 2009
COLUMBUS, Ohio—On their third stint without health insurance, the Wirebaughs worry that they are one accident away from financial ruin.
Barb Wirebaugh’s husband worked for the same company for more than 28 years until his job disappeared like so many others in the manufacturing industry. Then more jobs were found and lost, and the couple from Bucyrus in north-central Ohio have nearly given up on finding health coverage.
“I am just so, so tired,“ said Wirebaugh, who is running her own mental health counseling service. “I worry about so much. I am grateful to have my children on the coverage they have. I’m just worried that one disaster would wipe us out.“
Their three children are on Medicaid, but Wirebaugh and her husband are like roughly 1 million other adults in Ohio’s downtrodden economy - jobless or employed, and without coverage. Not only have workers lost their jobs in the onslaught of the recession, many small businesses are no longer able to afford insurance policies for their employees.
Gov. Ted Strickland faced a quandary as he tried to address the plight of the uninsured in his proposed budget: The number of Ohioans without health coverage is growing when the state can least afford to do anything about it.
The percentage of uninsured adults between ages 18 and 64 went from 15 percent in 2004 to 17 percent in 2008, according to the 2008 Ohio Family Health Survey.
Strickland developed plans he said would give an additional 110,000 uninsured Ohioans access to health coverage with an impact of only a few million dollars on state revenue. The state could not afford to pursue more aggressive measures that could help more than just a fraction of the uninsured population.
And what the state can do to help the uninsured will likely have an impact elsewhere.
“Someone’s cost is someone else’s revenue,“ said Bill Hayes, president of the Health Policy Institute of Ohio, a nonpartisan organization that conducts research on health care trends and policies.
Small businesses already straining in the recession believe that cost will fall on them. The friction between expanding health coverage and protecting the interests of small businesses will be a key component in the debate over the roughly $54 billion budget now in the hands of the Republican-controlled Ohio Senate.
“We tried to craft it (the insurance proposal) in a way so that everybody could support this,“ said Doug Anderson, chief policy officer at the Ohio Department of Insurance.
Strickland wants to require insurance companies to offer coverage to children of employees up to age 29 in the plans they offer businesses. That is an effort to help some of the estimated 371,000 Ohioans between the ages of 19 and 29 without insurance.
The plan, which also would extend tax deductions for the coverage of the adult children, is expected to cover an additional 21,650 individuals at a loss of $6 million in state tax revenue.
Another plan attempts to address the lack of affordable coverage for those searching for insurance on their own, particularly the elderly and those with pre-existing conditions. It caps premiums at 1.5 times the premium rate offered by business policies to cover individuals who have the same health characteristics.
The Strickland administration expects 52,000 more people to be covered under the plan. However, covering the older and sicker under lower rates is expected to increase overall rates for everyone else purchasing insurance on their own by 5 percent.
Finally, Strickland wants businesses that don’t offer insurance to set aside a tax-deductible account for employees to pay for coverage with their own earnings. The administration expects individuals to save anywhere from 21 percent to 34 percent off their premiums, enabling about 37,000 more Ohioans to be covered.
The Democratic-controlled House also added to the budget plan a requirement that insurance companies cover treatment for autism.
That requirement could place an additional $120 million in costs on the backs of small businesses, said Ty Pine, legislative director for the National Federation of Independent Business-Ohio. And while the Strickland administration says the cost for the coverage of dependents up to age 29 will be borne by the employee, Pine said the legislation isn’t written in a way that will shield businesses from all costs.
“These are things that employers need flexibility to work on with their employees,“ Pine said. “They need to decide what is best for them and their resources. ... If government continues to limit the ability of small businesses to attract and retain the right people they are going to continue to lose them to other states and bigger businesses.“
Thom Coffman, owner of the 61-year-old Clarmont Restaurant in Columbus, no longer has an employer-sponsored health plan for his roughly 40 employees because it became too expensive.
“When I first started out it cost me $3,000 a month,“ Coffman said. “Ten years later it was $15,000 a month. It got to the point I could no longer pay $15,000 a month.“
Small businesses don’t speak with one voice about Strickland’s proposals. Coffman favors the autism requirement because he thinks it will help employees. But he fears the requirement to cover employees’ children up to age 29 will lead to only the sickest of an otherwise generally healthy population opting into coverage, driving up costs for everyone else.
The Strickland administration maintains that the costs on small businesses will be minimal.
“We thought we were taking measured steps forward so that more people were getting covered without having big negative effects,“ Anderson said. “Even in these tight budget times we are trying to take a step forward.“
Wirebaugh doesn’t know whether any of the governor’s plans would help her family.
“Whatever they proposed, the need is immediate,“ she said. “Whatever changes are made at this point are going to take several months to put into action.“
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