Becky Rand would like to offer health care coverage for employees at her restaurant – Becky’s Diner on the Portland waterfront – so she’s crunching the numbers to see if it’s financially possible.
“I’m looking into coverage for the whole restaurant. I’m hoping this is the year,” said Rand, who hosted an Affordable Care Act event Tuesday at the diner. “I believe it’s important. I would love it if everyone could have insurance.”
On hand at the diner to tout the ACA were Mayor Michael Brennan and Christie Hager, regional director for the U.S. Department of Health and Human Services.
Up to now, Rand has been gently encouraging her 30 full-time and 20 part-time employees to consider buying coverage through the ACA’s health insurance marketplace, which kicked off its second open enrollment period on Saturday. People can sign up on the marketplace through Feb. 15.
The marketplace is where those without insurance – including those who work but can’t obtain coverage from an employer – can purchase subsidized individual insurance.
“The kids never think they’re going to get sick,” Rand said. “But you never know what’s going to happen to you.”
The marketplace enrolled 44,000 Mainers for coverage this year – 7.1 million nationwide – and health care advocates hope thousands more uninsured Mainers will obtain benefits for 2015. Emily Brostek, executive director of Consumers for Affordable Health Care, an Augusta nonprofit that advocates for reforms and helps people purchase insurance on healthcare.gov, said the statewide network of groups that helps people sign up has been “slammed” with calls this week from potential enrollees.
Nationally, news reports said 100,000 people applied for coverage on Saturday, a sharp contrast to the glitch-filled rollout last year when the website did not work smoothly for months. State-by-state numbers are not yet available, and are typically released monthly.
Mike Sajecki, a cook at Becky’s Diner, said he didn’t need any convincing from Rand, and had purchased an ACA plan for 2014. Sajecki, 27, said he mostly had been without insurance in recent years, forcing him to pay out-of-pocket for several ailments, including a collapsed lung that cost him $12,000.
“I’m still paying that one off,” he said.
Sajecki said a few years before the ACA marketplace began offering insurance for 2014, he purchased an individual policy. But with a $500 monthly premium, it was too expensive and he had to drop coverage. The ACA plan he’s now using costs $230 per month and includes dental and vision.
“I can afford that,” the Portland resident said.
Rand’s business is too large to be eligible for tax credits that reduce health care costs for small businesses with 25 or fewer employees. However, Mitchell Stein, an independent health policy analyst, said the federal government also has set up a marketplace for small businesses – called SHOP – that in theory should make offering health coverage more affordable for businesses than in the past.
“The marketplace is having insurance companies compete with each other to keep the rates low, just like for individuals,” Stein said. “But each company is going to have to make its own decision. Everyone realizes it’s not going to be the right decision for every small-business owner.”
The ACA mandates that businesses offer employees health benefits or pay a penalty, but exempts businesses with 50 or fewer full-time employees.
According to one Maine legislative report, as many as 80 percent of Maine businesses have fewer than 10 employees.
Dave Cousens, president of the Maine Lobstermen’s Association, said at Tuesday’s event that his health care costs were cut in half, and he persuaded his three sons, all lobstermen, to obtain ACA coverage.
“If you own a business, and you don’t have health insurance, your whole livelihood is at risk,” Cousens said. “Fishermen don’t like change, but they’re hearing success stories. I just tell them to check it out.”
The Maine Lobstermen’s Association is promoting ACA coverage to lobstermen through an $80,000 federal grant. The group has met with thousands of lobstermen and helped hundreds sign up, although the group does not know how many completed the process and obtained coverage.
Hager, the federal DHHS official, said grass-roots efforts – including personal appeals like Rand’s to her workers – are what make the ACA effective.
“The ACA is working in Maine, working in Portland and throughout the country,” Hager said. “This is a three-month enrollment period, and all hands are on deck.”
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