October 1, 2005
Jonathan Maze
 
For most employers, higher health care costs mean lower profitability. When that employer is a charity, higher health care costs mean fewer services to those in need, many of whom are themselves victims of skyrocketing insurance premiums.

"The prices are outrageous," said Bradley Childs, executive director of Lowcountry AIDS Services, which has 12 workers and pays $5,000 a month in health benefits, or $60,000 a year. "The higher the health costs, that decreases our client services."

To keep offering that coverage, Lowcountry AIDS bought insurance that costs less but has higher deductibles. It's a problem just about every South Carolina employer faces as health care costs march upward much faster than the rate of inflation.

With little indication of this trend ending soon, four South Carolina advocacy groups will start pushing the state to find solutions by holding three forums beginning with one at 9:30 a.m. today at the Charleston County Library downtown. Later forums will be held in Florence and Greenville.

The organizations include the Appleseed Legal Justice Center, the South Carolina Association of Non-Profit Organizations, South Carolina Fair Share and the South Carolina Small Business Chamber of Commerce.

The groups hope to get the attention of state policymakers with a handful of proposals they believe could ease the state's health care crisis. Among them: efforts to address some of the costs insurers face that drive up premiums, and ways to use primary-care providers to help small employers provide some health care to workers.

"We've got to get some momentum on the debate," said Frank Knapp, executive director of the small-business chamber. "We have not had a debate on the issue, and we have to have it because it's only going to get worse."

Health insurance costs have been skyrocketing for years. Family premiums have increased 66 percent in just the last five years, according to the Kaiser Family Foundation. This year, premiums grew 9.2 percent over last year, and various studies project a similar increase next year.

To offset those costs, employers are imposing higher deductibles, leading more workers to choose no coverage at all. And more companies are dropping coverage altogether. In 2000, 69 percent of employers in the Kaiser study offered coverage. This year, that figure fell to 60 percent.

The smaller the employer, the less likely it is to offer coverage, according to Kaiser: 47 percent of small businesses with three to nine employees offered insurance compared with 98 percent of businesses with 200 or more workers.

According to the U.S. Census Bureau, about 609,000 South Carolinians had no insurance coverage last year, an increase of nearly 53,000 from 2003 and 100,000 in just the previous two years. Another study, from the state Department of Insurance, puts the number of uninsured South Carolinians at 850,000.

"That is unacceptable," said Sue Berkowitz, executive director of the Appleseed center. "This is one of the wealthiest nations in the world. We shouldn't have anyone in this state who will go without health care."

Because nonprofit agencies typically are small, they struggle with rising health care costs just like small businesses. It's uncertain how many nonprofits don't offer coverage. "My guess is, just like small businesses, there are many nonprofits that are unable to provide that," said Erin Hardwick, executive director of the South Carolina Association of Nonprofit Organizations.

Nevertheless, nonprofits also deal with many people who are poor and uninsured, so they're concerned about rising health care costs, Hardwick said. And it would be difficult for many to advocate for those clients when their own workers don't have coverage.

Carolina Youth Development Center struggles with rising insurance costs every year. But this year it managed to negotiate a small decrease in premiums with its insurer by buying a plan with higher doctor and drug co-pays. The plan, which covers 50 of its 70 workers, costs about $15,000 a month.

"We were trying to maintain as much funding as possible to provide services to children," said the agency's CEO, Barbara Kelly Duncan. "That was the trade."