Kristi Whitfield and David Glazier share several things in common.
Both own a small business with their spouse, and both companies are located in the Washington area, one on either side of the Potomac. In addition, each business relies partly on some eye-catching vehicles.
One area where they differ: their thoughts on Obamacare.
“Oh my gosh, it has been great for us,” said Whitfield, one of the owners of a small cafe and cupcake truck company in the District, referring to the new health-care law.
“It’s very challenging, very frustrating,” said Glazier, who with his wife runs a luxury car service and transportation company in Alexandria.
Glazier and Whitfield are among the millions of small employers around the country trying to adapt to changes stemming directly and indirectly from the health-care overhaul. Now entering the second year under some of the law’s key provisions, the reviews from small employers have been anything but uniform.
Some say they can now afford plans for the first time, thanks to new government-run insurance exchanges, which relaunched in many states this weekend after a troubled rollout last fall. On some of the small-business marketplaces, which operate separately from the well-known individual exchanges on Healthcare.gov, rates have been lower than in the private market. And for some employers, new tax credits available through the exchanges, have lowered the cost of offering coverage even further.
Other small businesses haven’t fared nearly as well. New coverage standards have resulted in some companies’ plans being cancelled, while others say their premiums have skyrocketed as insurers conform to the new rules. At the same time, technical glitches and a shortage of insurance providers on many of the small-business exchanges have rendered them essentially useless for employers in certain states.
And there are more changes to come. Some of the law’s most important provisions have yet to take effect, including those that could make the statute more helpful to companies (such as the ability to offer different plans to different workers through the exchanges) and other rules that could make it a tougher pill to swallow (such as those requiring some employers to start providing health coverage or face a steep penalty).
As a result, it remains to be seen exactly how businesses will ultimately fare once all the parts are in place. For now, here’s a look at how the health-care law has affected a pair of companies in Washington — one for the better, and one, well ...
Kristi Whitfield was working as a consultant in Washington when her then-boyfriend, Sam, an attorney, pitched a business idea her way.
“A bunch of people in his office wanted cupcakes, but nobody wanted to schlep out and get them,” Whitfield said. “So he asked, ‘What do you think about a cupcake truck?’”
Now five years later, the Whitfields own Curbside Cupcakes, which started with some bright-pink cupcake trucks and has since expanded to a kiosk inside Union Market and a new cafe on 15th Street SE in the District. Not including the couple, Curbside Cupcakes employs five people, including one full-time and four part-time employees.
Until last year, the company couldn’t afford employer-sponsored health insurance, according to Whitfield. The group plans they found were simply too expensive, so they purchased individual plans for themselves.
“We knew for a long time that we wanted to have health insurance through the company and offer it to our employees,” Whitfield said, noting that the move made sense from a business perspective, to keep employees healthy and productive, but more importantly, it just seemed like the right thing to do. “It was a principled decision.”
So, when D.C. health officials started the city’s small-business marketplace last year — one of the few in the country with an online shopping portal—Curbside’s owners immediately created an account and started flipping through the plans. In the beginning, Whitfield said, “it was kind of a nightmare,” explaining that the site crashed several times and that “it was hard to find some of the answers we needed.”
In her mind, though, what else would you expect?
“It would be shocking if there weren’t some early problems for a first rollout like that,” she said. “We took a patient approach, and I think that was important. We knew that the benefits could be worth it.”
Indeed, they were. Whitfield says the small-business plan they purchased last fall through the exchange from CareFirst Blue Cross provides at least as good if not better coverage than the individual plan she and her husband had previously, yet it costs them roughly $300 less per month — and that’s not including tax credits the company can apply for to help cover some of that cost.
Because Curbside has fewer than 10 employees, the owners are eligible for credits in the law that, starting this year, will increase from 35 percent to 50 percent of a company’s health costs (companies with between 11 and 25 workers can apply for a smaller credit). Also starting this year, the credits are only available to employers who buy plans through the state-run exchanges (during the past three years, any company with fewer than 25 workers that offered health insurance could apply for a credit).
“There was the promise of it being more affordable, and then as it turns out, it actually was,” Whitfield said. “It just made good business sense. I mean, if you can get the same or better coverage for less money, why wouldn’t you?”
One of their employees, who was previously uninsured, has already enrolled in the plan, and another has expressed interest in signing up this year (some of the company’s newest employees must wait a few more weeks before they are eligible).
In addition, their workers can choose from several plans from CareFirst, each with different rates and varying levels of coverage, thanks to a new feature commonly called “employee choice.” Intended to be available in most states, the District’s small-business exchange is one of few around the country that has built in that option.
“Some people may want to be covered for everything, others may just want to be covered if they’re in the hospital,” Whitfield said. “This gives them some options.”
Not everyone on her team was enthusiastic, though.
“We had an employee who was afraid,” Whitfield recalls. “She said, ‘Oh no, you’re going to make me have that Obamacare.’ I said, ‘I’m not going to make anyone have anything, but honestly, you might benefit from it.’”
The Whitfields understand the value first hand. They spent much of the past month at Children’s National Medical Center with their two-month old son, Samuel, who had fallen ill. Upon returning home last week (with their son back in good health), Whitfield said she had the opportunity to catch up on some of the mail she had been missing.
“It was very reassuring to open claim notice after claim notice saying ‘You owe nothing, you owe nothing, you owe nothing,’ ” she said. “I would be bankrupt if I had to pay for the care that my son has needed.”
After graduating from the University of Maryland, David Glazier worked for a ground transportation company in the District before setting out on his own in 2000. He started with one bus.
Glazier’s wife, Stacey, came on board eight years later, and the couple has since built Fleet Transportation into a 25-vehicle luxury transportation company serving individual, corporate and government clients throughout the Washington region. They now employ 35 people; 15 full-timers and about 20 part-timers.
“It grew slowly and organically,” Glazier said.
Glazier started offering health insurance through the company nearly a decade ago. He said he believes he has a moral obligation to provide health coverage to his workers.
Until the past couple years, his rates normally increased by around 10 percent or 15 percent from year to year, with an occasional surge of about 20 percent — but never much higher. Finding ways to absorb the added costs was challenging, but manageable.
That changed around the time the health-care law started setting in.
Last fall, Glazier received notice from his insurance carrier at the time, United Healthcare, that his rates would increase more than 50 percent for his existing plan. A new broker helped him find and purchase a slightly less expensive plan from CareFirst Blue Cross, but the price hike still dealt a heavy blow.
It was the same story again this fall, when Blue Cross informed him his premiums would increase by nearly 60 percent — a bump Glazier said his company simply couldn’t afford.
“When the government steps in and sets these new inclusions and requirements for plans, prices are going to go up,” said Glazier, referring to new minimum standards governing all health plans, which insurers say have contributed to rising prices. He noted that “it’s great that things like preexisting conditions can no longer be a factor, but when you require, for instance, maternity coverage on every plan, this is what happens.”
Glazier had hoped the new small-business exchanges would present him with more affordable plans. However, unlike in the District and Maryland, Virginia officials elected not to set up their own exchange, defaulting to one run by the federal government. In many ways, that federally run employer site has seen even more delays and technical problems during the first year than the much-maligned individual marketplace.
Days before the federal exchange was set to open last October, officials announced that the online shopping portal for small businesses would not launch until November 2013. Two months later, they delayed the start until November 2014. As a result, Glazier and many other small-business owners interested in plans on the exchange have had to work with brokers to find out what plans were available and apply via paper applications.
With the online federal exchanges reopening this past weekend, Glazier recently attempted to sign into the account he created last year — but he still encountered problems.
“I tried to log in but couldn’t remember my password, so I clicked to get my password, but it never e-mailed me anything,” he said. “So, I called the 800 number and sat on hold for about 45 minutes. I don’t have the time for it.”
It may not be worth the effort. His broker alerted him about a plan on the exchange this fall, but the rates were again 50 percent higher than what he was paying this year. “From what my broker tells me, the exchanges in Maryland and D.C. have some better options,” Glazier said. “But obviously we can’t take advantage of that.”
Moreover, by adding the hours worked by his full- and part-timers, he now has too many employees to apply for much (if any) of the tax credit available through the exchanges.
“I was so fed up and frustrated, I considered just giving up entirely and dropping our coverage,” Glazier said. With fewer than 50 workers, Fleet is exempt from rules in the health law requiring employers to provide insurance or pay a fine. “But I said, ‘You know what, I just can’t do that to my employees.’”
His broker helped him find a Blue Cross plan that provides many of the same benefits he once had. But there’s a catch: the deductible (the amount individuals must pay before insurance payments kick in) on the new plan is 150 percent higher than on this year’s plan.
That allowed Glazier to keep the annual cost increase sustained by the company at a still-high but manageable 32 percent, but only by more than doubling how much he and his workers must pay — from $600 to $1,500 next year — before the benefits take effect.
In addition, the new plan doesn’t have composite rates (an option he was hoping to find), which would have meant each of his workers would pay an equal monthly contribution based roughly on the average of all their ages.
Instead, “some of our younger employees saw their weekly contribution go down from $45 to around $36 a week, but our older guys, the ones who absolutely need the insurance, they have seen their weekly contribution go from $45 to as much as $90 a week,” he said.
“One of my employees asked, “Why is this so expensive?’” he added. “ I have to explain to them, “Look, I don’t choose the premiums.’ ”
Glazier expects there will be a lot of small employers who aren’t required to provide coverage that will nix their plans and send their employees to the individual exchanges. Question is, will he eventually be one of them?
“I would really like to continue offering it,” Glazier said, adding that he remains hopeful policymakers will find ways to improve the Small Business Health Options Program exchanges. But with little reason to expect rates to stop climbing, he said he remains “on a case-by-case basis every year” and “will continue looking at the alternatives.”
“It’s just frustrating, because Obamacare was supposed to make all this easier,” he said. “But it hasn’t.”