Bulletin

The State Health Access Reform Evaluation (SHARE) has released an issue brief, entitled Participation in the New Mexico State Coverage Insurance (SCI) Program: Lessons from Enrollees. This is the second of two issue briefs that present results from a study of small business participation in SCI conducted by The Hilltop Institute. The study identifies the characteristics of non-sponsored enrollees in SCI and shares lessons learned about employer sponsorship of enrollees in SCI and similar public/private partnerships.

New Mexico’s SCI program is a public/private partnership that provides access to subsidized health insurance for uninsured adults aged 19 through 64 years with household incomes below 200 percent of the federal poverty level (FPL). The program is a health care coverage option offered to workers with low incomes through small businesses and is jointly financed by private (employer/employee) contributions and public (state/federal) funding. Working and non-working adults with low incomes may also enroll directly into the program without an employer sponsor.

Study findings were drawn from two sources: a 2008 survey of individuals enrolled in SCI without group sponsorship and an analysis of program administrative enrollment data. The survey asked questions about the nature of the enrollees’ employment; their employers; the SCI application process; the affordability of SCI; prior health insurance coverage; the health insurance of family members; household income; and other demographic information. SCI administrative data were analyzed to understand the effects of program interventions on SCI enrollment.

The brief identifies four lessons learned about encouraging employer sponsorship of enrollees in these types of programs:

The first issue brief, entitled Small Business Participation in the New Mexico State Coverage Insurance Program: Evaluation Results and published by The Hilltop Institute in January 2010, described the characteristics of the businesses that participate in, or have inquired about, SCI; their experiences with SCI; concerns that they have about the administrative and cost burdens of sponsoring SCI; and their experience in offering health insurance to their employees.

Researchers concluded that SCI may serve as an example of what to expect under the Affordable Care Act (ACA), which uses tax cuts and participation in health insurance exchanges to encourage small business to offer health insurance to their employees. Although it is expected that additional variables will come into play once the ACA takes full effect, SCI is one of the few current examples of public/private initiatives to be examined in a post-reform environment. These findings highlight the importance of financial subsidies and size for small businesses and should be considered as ACA implementation moves forward.

The evaluation was partially funded by the Robert Wood Johnson Foundation’s State Health Access Reform Evaluation (SHARE) program through a partnership between the New Mexico Human Services Department (HSD) and The Hilltop Institute. SHARE is directed by the State Health Access Data Assistance Center (SHADAC) at the University of Minnesota School of Public Health.

To learn more about the study, contact Laura Spicer.