Today, 12bet官方研究所发布的新数据显示，在个人市场上购买医疗保险的小企业主面临着保费成本不断增长的问题，保费成本超过了收入的运营支出. In 2014, 16 percent of individual market participants were self-employed.

While growth rates in insurance premiums have slowed in recent years, from 10 percent in 2014 to 7 percent in 2017, 典型的小企业主每月仍然要花大约500美元来支付自己和/或家人的保费. Additionally, the data show small business owners who paid at least 6.2016年，5%的医疗费用支出更有可能停止支付医疗费用，并可能在接下来的一年完全离开市场.

The report, Paying a Premium: Dynamics of the Small Business Owner Health Insurance Market 提供了对小企业主作为个人健康保险市场参与者的决策的洞察，并提供了一个独特的视角，以了解健康保险费相对于小企业主面临的其他运营费用的幅度.

“大多数美国小企业主在为自己和家人购买保险时面临着真正的经济负担," said Diana Farrell, President and CEO, JPMorgan Chase Institute. “小企业在脆弱的环境下经营，一般小企业只有 27 cash buffer days. 这些企业非常容易受到收入冲击的影响，医疗保险费对这些企业主来说是一项重大的、不断增长的运营成本. As policymakers consider the path forward on healthcare, it’s important to keep these small businesses in mind as we look for solutions."

More than 75 percent of small businesses are nonemployer firms, including sole proprietors, contractors and freelancers, representing the overwhelming majority of America’s small businesses. Of the 29.6 million small businesses in the US in 2014, 23.8 million were non-employer firms.

而提供医疗保险的小雇主所面临的问题已经引起了极大的关注, there is limited research on the topic for nonemployer small businesses.

Some of the report’s key takeaways include:

• Health insurance premiums have increased dramatically in recent years, but the rate of growth has decelerated over time. Small business owners saw their premiums grow 10 percent in 2014, though that growth rate declined to 7 percent in 2017.

• 小企业主的医疗保险费的增长速度远远快于他们的运营费用. In 2014, the median health insurance premium burden was 2.3 percent. In 2017, the median burden among the same set of firms had grown to 2.9 percent, increasing about 0.2 percentage points each year.

• 承担最高保险负担的小企业主正在离开个人市场, and possibly going without health insurance. Forty-two percent of firms in the sample with health insurance payments amounting to 6.一年后，他们在2016年4月的支出中，有5%或更多不在样本中. 与健康保险费负担较低的公司相比，健康保险费负担较高的公司更有可能在第二年离开样本，最常见的原因是它们停止了这些支付.

The sample was constructed from more than 30,000家在大通银行拥有商业银行存款账户并定期从这些账户支付医疗保险费的非雇主公司. 12bet官方研究所利用这些企业的1.17亿笔匿名交易，制作了2014年1月至2017年4月期间每月医疗保险费支付和其他运营费用的视图. To support some analyses of within-firm payment changes, the JPMorgan Chase Institute also constructed a panel sample, comprised of 3,505 firms that appear in the cross-sectional sample (described above) every month.

Key Findings: Paying a Premium: Dynamics of the Small Business Owner Health Insurance Markets

• Health insurance premiums are a material expense for nonemployer business owners, who spend about $500 per month on health insurance premiums.
  • 典型的非雇主企业主支付的健康保险费为2美元.5 percent of overall expenses in a given month in 2017.
    In addition to being a material expense, 在过去三年中(2014年4月至2017年4月)，保费支付中位数增加了11%.6 percent, from $449 to $502.
• 对于没有雇主的企业主来说，医疗保险费是一个日益沉重的经济负担, whose health insurance payments have grown substantially since 2014.
  • Our longitudinal data allows us to analyze the experiences of individual firms. 小型企业部门的活力可能会在汇总的横截面数据中掩盖这些经验. We investigated intra-firm health insurance premium payment growth, not only in our full sample that allows entry and exit, 而且在样本期内每个月都有公司的纵向面板中也有.
  • Nonemployer small businesses experience typical HIPP growth rates of 7-10%.
  • Most nonemployer firms experienced substantial health insurance premium growth, significantly faster than the growth of their other operating expenses.
  • 2014年，负担中位数(医疗保险费支付占所有费用的比例)为2%.3 percent. In 2017, the median burden had grown to 2.9 percent, increasing about 0.20 percentage points each year.
  • 保留医疗保险的小企业主用于经营业务或养家糊口的资金份额越来越少.

• 自2014年以来，个体企业的医疗保险费增长率有所放缓.
  • 企业内部医疗保险费的中位数增长率从2014年的10%左右放缓至2017年的7%左右.
• 医疗保险费负担最重的非雇主企业正在退出医疗保险市场.
  • 42 percent of firms in the sample with health insurance payments amounting to 6.5 percent of expenses or more in April 2016 were no longer in the sample a year later.
  • 高HIPP负担的公司更有可能在第二年离开样本-与HIPP负担较低的公司相反-最常见的原因是他们停止了HIPP支付.
  • We don’t have insight into the reason small businesses discontinued HIPP payments, but if they stopped paying health insurance altogether, 他们的企业和家庭可能特别容易受到庞大和意想不到的卫生保健支出的冲击.
  • 我们没有发现证据表明小企业主因为高HIPP负担而倒闭.

• 非雇主小企业健康保险保费支付水平和负担在大都市地区和行业之间差异很大.
  • Median HIPP levels are not consistent across location of a business, or industry in which a business operates.
  • Premium payments within metro areas also varied over time, in addition to variation in premium payment burdens.
  • There was no clear relationship between median HIPP level and burden by industry.

   

Click here to read the full report