Editorial: Health act needs explaining


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President Obama’s State of the Union Address last week marked a major shift in his approach to the Affordable Care Act: talk about it more.

The president spent about five minutes of airtime, 7 percent of his speech, extolling the health-care insurance overhaul, the most time he’s spent on the topic in a State of the Union address since he urged Congress to pass the act in 2010.

With the March 31 deadline for insurance signups on the act’s electronic exchanges looming, Obama’s decision to devote more time to his signature reform is prudent. A recent poll by finance website bankrate.com found only 45 percent of the respondents were aware that they needed to carry health insurance by the end of March to avoid a fee, and some thought they had the entire year to purchase health insurance.

And in Iowa, where those wanting to signup have had to rely on the troubled healthcare.gov website, many small businesses are less than knowledgeable about the Affordable Care Act and skeptical about its features, according to a study published last week by the University of Iowa Public Policy Center.

One aspect of the Affordable Care Act that drew fire from opponents was its possible effect on small businesses, leading to the implementation of the Small Business Health Options Program. Offering a web portal to compare health plans, the program was designed to smooth the process for smaller employers.

Despite tax credits worth up to 35 percent (in some cases, up to 50 percent) of the cost of insurance premiums are available to companies with fewer than 50 full-time employees by using the program, the Public Policy Center’s study found small businesses preferred working with an agent or broker to purchase insurance for their employees and weren’t comfortable making decisions and purchasing coverage online.

It’s a major problem for a program that is almost entirely based online and one that may take more than time set aside in a speech to fix. The health-care law is complicated by necessity, and that complexity seems to be too much to dig through for small businesses.

On Affordable Care Act components, large businesses were much more knowledgeable, even on the provisions made to help small employers. The study found 75 percent of companies with more than 50 employees were knowledgeable about the online marketplaces, while only 55 percent of those with fewer than 50 employees could say the same.

Attitudes toward the provisions in the law followed a similar pattern. Most of the act’s components (such as the marketplaces and individual mandate) did not get more than 50 percent support from small businesses. The business tax credit to ease their burden received only 56 percent support.

The country seems to have moved on from discussing the Affordable Care Act, perhaps weary of the partisan battle over the reform that shut down the government for more than two weeks. But in the final few months before the signup deadline, its obvious that more time should be devoted to informing the public, and especially small businesses, on what the law will require and what it will provide.

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