The gap in access to employer-sponsored health insurance is widening between workers at large companies and employees of small businesses, according to figures from a new Commonwealth Fund report.
Just 49 percent of workers in businesses with fewer than 50 employees were offered and eligible for job-based health insurance in 2010, down from 58 percent in 2003. Meanwhile, 90 percent of workers in firms with 100 or more employes were offered and eligible for health insurance in both 2003 and 2010, the report says.
Forty-five percent of small-business employees reported trouble paying medical bills in 2010, and 46 percent reported that they skipped needed medical care because of cost. In contrast, 33 percent of workers in firms with 50 or more employees reported problems paying medical bills, and 35 percent did not get needed medical care because of cost.
Low-wage workers in small businesses were the least likely to be offered and eligible for coverage. Just one-third of workers making less than $15 an hour in small firms were both offered and eligible to enroll in their employers' health plans, compared to 70 percent of small-firm workers making over $15 an hour.
"Many people who work for small businesses can't afford the health care they need or have medical bills they are unable to pay," report co-author and Commonwealth Fund Vice President Sara Collins said in a press statement. "The Affordable Care Act should mitigate this trend by improving the affordability and comprehensiveness of health insurance both for small-business owners who want to offer health benefits and for workers in small businesses who can't get coverage through their jobs."
The report authors estimate that most of the 27.6 million uninsured workers with low and moderate incomes in small and large firms will be eligible for subsidized private health insurance through the new state-based health insurance exchanges or through Medicaid, the federal and state program for low-income people.