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Small Group Employer Participation in New Mexico's State Coverage Insurance Program: Lessons for Federal Reform

Authors

  • Anna S. Sommers,

    1. Center for Studying Health System Change, 600 Maryland Ave. SW, Suite 550, Washington, DC 20024-2512
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    • Address correspondence to Anna S. Sommers, M.A., M.S., Ph.D., Center for Studying Health System Change, 600 Maryland Ave. SW, Suite 550, Washington, DC 20024-2512; e-mail: asommers@hschange.org. Jean Marie Abraham, Ph.D., is with the Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN. Laura Spicer, B.A., is with the Hilltop Institute, University of Maryland, Baltimore, MD. Asher S. Mikow, M.H.A., is with the DHHS/CMS/OA/CMCS/FMG/DRSF, U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, Baltimore, MD. Mari Spaulding-Bynon, J.D., is with the Blue Cross Blue Shield of New Mexico, Legal Department, NE, Albuquerque, NM.

  • Jean Marie Abraham,

    1. Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN
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  • Laura Spicer,

    1. Hilltop Institute, University of Maryland, Baltimore, MD
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  • Asher Mikow,

    1. DHHS/CMS/OA/CMCS/FMG/DRSF, U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, Baltimore, MD
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  • Mari Spaulding-Bynon

    1. Blue Cross Blue Shield of New Mexico, Legal Department, NE, Albuquerque, NM.
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Abstract

Objective. To identify factors associated with small group employer participation in New Mexico's State Coverage Insurance (SCI) program.

Data Sources. Telephone surveys of employers participating in SCI (N=269) and small employers who inquired about SCI (N=148) were fielded September 2008–January 2009.

Study Design. Descriptive and multivariate analyses investigated differences between employer samples, including employer characteristics, concerns that applied to the business when deciding whether to participate in SCI, prior offerings of insurance to workers, and perceived affordability of the program.

Data Collection/Extraction Methods. Unweighted employer samples yielded 88 and 75 percent response rates for the participating and inquiring employers, respectively.

Principal Findings. The administrative issue most commonly selected by inquiring employers as applying to their business was difficulty understanding how eligibility requirements applied to their business and its employees (53.5 percent). Inquiring businesses were significantly more likely to report concern about affording to pay the premiums in the first month (35.6 versus 18.7 percent) and the cost to the business over the long run (46.5 versus 26.6 percent) relative to participating employers. From the model results, businesses with the fewest full-time employees (zero to two) were 19 percentage points less likely to participate relative to businesses with six or more full-time employees.

Conclusions. Administrative and cost barriers to participation in SCI reported by employers suggest that the tax credit offered to small businesses under new federal provisions, which merely offsets the employer portion of premium, could be more effective if accompanied by additional supports to businesses.

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