Like the health insurance exchanges that are being developed for 2014 now, the law in Massachusetts also provided an exchange for individual and small groups to buy health insurance. John Hurst, president of the Retailers Association of Massachusetts told PwC that small businesses paid a price (read: higher premiums) for buying coverage on the exchange because the employers subsidized too many unhealthy individuals.
Hurst called the move a "very big mistake," and the HIX dynamic in Massachusetts is one health insurers are wary of seeing happening nationwide next year.
But what HRI's also points out is that it is cheaper to include health coverage with an employee's salary because of tax exclusions. Employees also benefit, as the study's authors found take home pay increased when their companies offered health insurance.
The second report from HRI on the Massachusetts Experience will be out later in May, and will show possible implications for hospitals, physicians, and insurers.