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Health care reform bill debated by audience at local forum

Professor Bart Finzel of the University of Minnesota Morris, right, is pictured Tuesday at Ridgewater College in Willmar. Finzel spoke during a public forum on rural health care coverage. Tribune photo by Gary Miller1 / 2
Virginia Wolking, a policy advisor with the Center for Rural Affairs in Lyon, Neb., addresses an audience Tuesday during a public forum on rural health care coverage. "I think small businesses are already suffering a lot," Wolking said of the threat small businesses face from higher rates of premium. Tribune photo by Gary Miller2 / 2

WILLMAR -- Most of the people who attended a forum Tuesday in Willmar on rural health care coverage said they know someone who's struggling to pay medical bills.

But there was strong pessimism whether the federal health care reform bill, which became law last week, will truly cure the ills it aims to fix.

"I am scared to death of what's going to happen to small businesses across the country," said Ken Warner, president of the Willmar Lakes Area Chamber of Commerce.

The bill's provision to mandate the purchase of health insurance will be disastrous, Warner predicted.

"It penalizes business. It all starts with the job, and there aren't going to be any unless you work for the government. It's disappointing," he said.

About a dozen people showed up for the forum, which was hosted by the nonprofit West Central Healthcare Purchasing Alliance. The meeting in Willmar was one of four being held in the region to share recent findings from University of Minnesota surveys of providers and employers, and to discuss the federal health care reform bill.

Similar forums are scheduled today in Morris and in Montevideo.

Many in the audience at the Willmar meeting saw the health care bill, which was signed into law last week by President Obama, as a step backwards, especially for the small businesses it purports to help.

Data from the two regional surveys conducted last fall by the University of Minnesota at Morris suggest that small rural businesses and farmers were struggling the most, however, under the previous system.

The findings indicate "the status quo was not particularly good in this area," said Bart Finzel, an economics professor at the U of M in Morris and a research specialist for the West Central Healthcare Purchasing Alliance.

Many of those who responded to the survey reported 15 to 20 percent increases in premium costs over the past year, compared to a national average of a 5 percent increase. Eleven percent said they were very likely to stop offering health insurance as a benefit if premium costs continue to rise, and 27 percent said they were somewhat likely to do so. Eight percent of the employers who filled out the survey had already stopped offering insurance within the past five years.

According to the survey data, the smallest businesses have been hit the hardest, Finzel said. Indeed, those who had switched to high-deductible plans or medical savings accounts to rein in costs were more likely to report they were considering dropping the coverage altogether, he said.

"Small employers are bearing even higher rates of premium increase than are large employers," he said.

The survey of health care providers in the region painted a similarly bleak picture. The majority reported their operating expenses were rising an average of 3 to 6 percent a year while reimbursement was going down. Fully 46 percent said the widening financial gap was threatening their viability as a provider.

"I think small businesses are already suffering a lot," said Virginia Wolking, a policy organizer with the Center for Rural Affairs in Lyon, Neb.

"Employers are trying to offer health insurance and are finding it cost-prohibitive," Finzel agreed.

The Center for Rural Affairs, which backed the health care reform bill, sees the new legislation as a benefit that will help make health care coverage more affordable and more accessible for small rural businesses and their employees, Wolking said.

"It really comes down to a rural development issue," she said. "There's a lot of things this bill does to allow small businesses to purchase health care for their employees."

In a show of hands, most of the people at the forum said they knew of someone who had difficulty paying their medical bills or affording prescription drugs. Yet most also said they were satisfied with their current health insurance and that they could see a doctor if needed.

There's still a high degree of uncertainty over how the changes in the health care reform bill will unfold, said audience member Debi Brandt of the Heartland Community Action Agency.

"There's so much unknown right now. We're not sure how it's all going to come together," she said.

Anne Polta

Anne Polta covers health care, business/economic development and general assignment. Her HealthBeat blog can be found at Follow her on Twitter at @AnnePolta.

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