As a small employer, I understand the importance of providing good health insurance to my employees. This is an important benefit that the Quality Institute wants to offer and is also essential to the health of our employees and their families. Until our country provides universal coverage or another method to pay for health care, the majority of employers will want to make sure that their employees have access to care. New Jersey has a strong history of small employers providing insurance benefits to their employees even though there is no mandate to do so. Unfortunately, New Jersey’s small employer market is in danger – as steep declines in enrollment and rising premiums create a dangerous spiral. Action must be taken to ensure that small businesses and their employees have access to affordable insurance coverage and quality health care services.

That is why the Quality Institute just released a white paper laying out the market’s background and setting out a comprehensive package of short and long term recommendations to support affordable health care coverage for small group employers and their employees.

As described in greater detail in our paper, enrollment in New Jersey’s small group market has been in a steep decline — down by 600,000 lives over the last decade. While significant steps have been taken to improve affordability and access for those getting coverage through Medicaid and the individual marketplace, small employers (those with 50 or fewer employees) struggle to provide quality and affordable coverage for their employees. As more individuals leave the small group market due to limited access or rising prices, the risk pool of those remaining in the declining market will continue to contribute to increasing costs and result in a dangerous downward spiral. Short-term efforts must be taken to stabilize the current small group market and limit negative impacts on employers and consumers. Additionally, long-term solutions aimed at overall affordability and transparency in the small group market and health care delivery system must be explored.

The economic repercussions of the COVID-19 pandemic are now exacerbating this already distressed market. For the first time, as of the end of the first quarter of 2020, there were more people enrolled in New Jersey’s Individual Market than its Small Employer Market. State leaders — both in the administration and legislature — are deeply concerned and have looked to the Quality Institute for actionable steps to ensure that small businesses can maintain health coverage for their employees and their families.

I encourage you to read the white paper. You may not agree with all the ideas and may have others to put on the table.  I welcome that dialogue. We want to preserve the strong consumer protections in our small employer market, such as guarantee issue and renewal, while allowing for greater flexibility in the market to offer coverage that is of high-value and affordable for small employers and consumers. We must act now.