Small business’ role in children’s health insurance

What role do small business owners have in providing health coverage for children of employees?

This question is increasingly significant as the federal government stalls and is apparently unwilling to issue funding for ‘CHIP’ programs that cover the children of nearly 9 million moderate income families that have historically been supported by the majority of lawmakers. Recent news reports indicate that the Senate is unlikely to approve the funding so states and employee benefits advisers like us are beginning to investigate alternatives. This article is meant to provide a preliminary checklist.

1. Small businesses are not required to provide health insurance to employees.
2. Businesses that do provide health insurance to employees are not required to provide it (or even make it available) to employees’ children.
3. Businesses that do provide employee health coverage typically cover children on the same plan and under the same terms as the employees.
4. CHIP often covers the children of parents who work in small businesses.
5. Until 2010, the United States was making strong positive progress in providing health coverage to low income children. I covered this topic here in 2011. Most of these initiatives were replaced by the Affordable Care Act (ACA).
6. The implementation of the ACA dominated coverage from 2012 until this year
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   , 2017. This federal law treated all low income people equally (although coverage varied depending on state and local markets).

7. The rollback of funding for ACA is the primary factor affecting children’s health insurance for lower income families in 2018.
8. The cost of children’s health insurance is less than the cost of adult coverage
9. In many cases small businesses are wise
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   , considering all the options and current laws, to provide supplemental health coverage and avoid providing primary health coverage to employees and their dependents.

10. Employee health plans can be modified to provide relief for employees’ children in the event of a cancellation of CHIP programs without disturbing other employer policies that are currently in force.

This blog post offers generalized comments for public presentation. Discussion is not customized for each state’s laws. Some of these points may not apply to your firm. Please seek individual guidance that applies to your firm and your state’s laws.