State Health Insurance Mandates, Consumer Directed Health Plans and Health Savings Accounts

Are They a Panacea for Small Businesses?

by Susan M. Gates, Kanika Kapur, Pinar Karaca-Mandic

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Small firms in the United States that seek to offer health insurance to their employees have historically reported problems with the availability and affordability of their options. The cost of health insurance has been the primary concern of small business owners for several decades. This paper examines the effect to date of two types of policy initiatives that could have substantial benefits for small business: state health insurance mandates and key components of CDHPs-HSAs, HRAs and high deductible health plans. It summarizes the key policy issues, reviews existing research evidence on the effect of these initiatives on small business and offer some conclusions for policymakers.

The research described in this report was conducted by the Kauffman-RAND Institute for Entrepreneurship Public Policy.

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