California small business owners support policies to expand health coverage access and lower costs
Despite California’s considerable progress in reducing its uninsured rate, millions in the Golden State are still uninsured and many more struggle to afford the premiums and co-pays for the care they do have, including many entrepreneurs and small business employees. Governor Gavin Newsom has unveiled a number of policy proposals intended to address these remaining access and affordability issues and restrain healthcare costs. New opinion polling shows California small business owners are decidedly supportive of these and other policy proposals under consideration by the state legislature.
The poll, an online survey of 300 small business owners in California, was conducted by Chesapeake Beach Consulting for Small Business Majority from February 22 through February 27, 2019. The survey reveals large majorities of California small business owners support expanding the existing system of premium subsidies that help people purchase insurance on the marketplaces. Additionally, more than 9 in 10 small business owners want more transparency on pricing and quality. Specific policy proposals to address the high costs of prescription drugs also received very high widespread support.
Sizable majorities also support additional policies to address costs, including a measure that would prevent people from receiving surprise bills for receiving out-of-network care at an in-network facility (89% agree) and by requiring that all individuals be required to maintain a basic level of health insurance in order to reduce healthcare costs (70% agree).
As the survey reveals, entrepreneurs would like to see California take further steps to strengthen the health insurance marketplace and address the state’s remaining uninsured rate by reining in costs and expanding access to coverage.
Key Findings
California small business owners support strengthening existing system of ACA subsidies to help more people afford healthcare premiums: Nearly 3 in 4 small business owners (73%) support strengthening the current system of ACA subsidies by creating additional state subsidies to provide cost-sharing for those who make under 400% of the federal poverty level (up to $100,400 for a family of four). Additionally, 7 in 10 small business owners also support expanding cost-sharing subsidies to individuals who make up to 600% of the FPL, which would impact middle class Californians who currently do not qualify for any premium assistance.
Figure 1: Small business owners support expanding premium subsidies
Below are some solutions that have been suggested to strengthen and enhance the ACA. Please indicate whether you strongly agree, somewhat agree, somewhat disagree or strongly disagree with each solution.
Small business owners want more transparency on pricing and quality in the healthcare system: California small business owners overwhelmingly agree that there should be more transparency on pricing and quality to allow patients to make informed decisions about where to receive care, a sentiment supported by 91% of respondents.
Figure 2: Small business owners want more transparency in healthcare pricing and quality
Small business owners support numerous proposals to lower the cost of prescription drugs: California small business owners strongly support numerous proposals aimed at controlling costs of prescription drugs, including allowing the state to leverage its purchasing power to negotiate lower drug prices for state plans (88%), making it illegal for a drug company to pay another company to delay the release of a generic drug (88%) and requiring drug companies to justify prices by disclosing how much they spend on production and how much they profit (85%).
7 in 10 small business owners agree that all individuals should be required to maintain a basic level of health insurance in order to reduce healthcare expenses by ensuring emergency care is covered and by increasing risk pools.
Nearly 9 in 10 California small business owners oppose the practice of “balance billing:” Balance billing is the practice in which a healthcare provider charges more money above what your insurance covers, usually as a result of receiving care from an out-of-network provider at an in-network facility. A strong majority of 89% of respondents agree California should work to ensure that anyone who receives care at an in-network facility be billed at in-network rates, regardless of their insurance.