Mercer also estimates that 40,000 people will join the small business exchange and 185,000 will join as individuals. This is substantially lower than a CT estimate by RAND for the Council of State Governments using a different model. Mercer estimates that only 5% of small businesses not eligible for subsidies will purchase coverage in the exchange and that many will drop coverage entirely, leaving their workers in the individual market. Board members noted that employers in MA did not drop coverage during their health reforms five years ago. Mercer acknowledged that these are estimates and a great deal depends on effective outreach and public education campaigns. Again, Board members are focused on low numbers of small businesses in MA’s exchange and asking “how can we avoid mistakes made in MA.” They are missing the larger point -- since their reforms and creation of their exchange, the percent of MA small businesses offering health benefits is up, while it dropped significantly in CT during those same years.
Mercer also found little impact of incorporating CT’s high risk pools into the exchange. They estimate that merging the small group and individual markets would lower individual premiums by 2% but raise small groups’ by 4%. Again this is different than what MA experienced – individual premiums averaged 33% less after reform. Mercer also found that the individual mandate penalty makes very little difference in the number of uninsured, even if the penalty was tripled from current law. (Is this where advocates say – I told you so?)