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Tuesday, July 28,2009 FOSSTON, MN 9,000 (1 19) Newspaper (W) 4 Center For Rural Affairs

Job Lock Phenomena 1118 EiL.rh/ G/.ce/c1*.Y///i/h,eL.rh~/.i@~jJ;;/. O I ; ~ Cc///c/. , ~ J I ~. ~ I I I I / A / ~ Z I T Somconc once told that \\-ork is llot fun, t1i:lt's uh!* it's called work. This person was stuck in an unsatisfactory job that the!, kept only because i t pro\.itletl health insurance. The! aspired to start thcir 011-n business, but i t \\-as t o o risk, The lack o f attordablc, health insur:tnce is the primar!. bi~rrierto entrcprcncurship reaching its potcnGal for rural people. l'hc cost of IlraltIl insul-ancc pl-c\.cnts small busincsscs and cnrl-cprcncurs from espantling thrir businesses and cre:lring jobs; t h r cost of hc:lIlh insurancc makcs it less likcl!. for rural small busincsscs t o provide hcaltli insurance to their employees, afkcting the he:llth o f their cmplo!.ccs and making i t more likelv t \ ] ~ \\\-ill . seek employment .in urban arcas. Iicalth insurancc costs also affect tlic dre:lms o f potential run11 entreprcllcurs, delaying o r killing an idea hy

m:lkint: i t too risky for o n e to leave employer-provided insurance at a current job, the so-called "job lock" phenomena. T h e rural economy is based on entrepreneurship, both agricultural and non-agricultural. Entrcpreneurs add jobs and create \\.calth. Spurring inno\-ation and job creation in rural communities through enlrcpreneur~hipis the key to revitalizing rural communities and cnsui-ing Rural America's long-tern~futul-c. PI-opel-I!. rlcvcloped and adninistcrcd, a public health insurancc plan could provide an affordable and quality choice to benetit the entrepreneurs o f rural America. I t \r-odd pro\.iclc a co\.erage option that does not currently exist ti)r rural small businesses t o pro\.idc health c:lrc co\.eragc f i x owners and cmplo!ecs, and k ) r rural families that arc pursuing their entreprencuri:tl clrc:lms.

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Q 2009 13 TOWNS All Rlghts Reserved

Account: 18209C (25422) MN~116

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Repub Zican-Leader etlon

Thursday July 30 2009 PRESTON M N C~rculat~on IDMA) 1 600 1153) Type ( ~ r e ~ i e n c ~ j ~ : e w s p a ~(W) & Page: 7 Keyword: Center For Rural Affairs

Analysis contends rural America needs public health insurance plan The Center for Rural Affairs in Lyons. Neb.. has released a report entitled. \Mly RurulA~ireric.rrNevri.s rr Pirhlic. Herrltlr 1rrslrrrrrrr.e Plrrn Optjoll. The report examines some the arguments for a public health insurance plan. how the public hcnlth insurance plan would address [Ile health care that exist for rural areas. and, ultiwhy the choice a public he;il[h insurance plan option is needed for rural America. In much the nllrinstrcam mctli;i ~ l l cti~'iilthcare dcbatc h;ir largcly been reported primarily as an urban issue. But this Center for Rural Affairs analysis dcmon\trates tllat rural people need hcalth care reform, and the option to obtain health insurance through :I public health insurance pl;ln. as much or more than their urban counterparts. "The current health insurance system does not work well for many rural people and rural businesses," said Jon Bailey. director o f research and analysis at the Center for Rural Affairs and author of the report. "They pay too much for too little coverage and too little p a c e of lnind. Health care reform that is based on the current system docs littlc to address the unique issues faced by many rural people - why should rural people he satisfied with maintain in^ 3 SyStCm that does not work for millions of them without significant reforms'? A public health insurance plan option is simply that- a choice that addresses many of the health inwrance issues and barriers faced hy rural people. families and businesses." A full copy of the report can be viewed and downloaded at l~ttp://files.cfra.org/pdf'/Public-Pla

n.pdf. "Rural prople have m ~ c hto gain from inclusion of 3 public health insurance plan option in health care reform legislation. possibly rllore than any other group in the $ltion." said Bailey. According to Bailey. rural Peaple ;ire subject to myriad risk fat$rs that lead to highcr rates of qeing without insurance and to ipsurance instability. Rural workqlacc characteristics such as reiltcr dependence on small busiess employment. more self+lployment. more low-wage york. and rural health disparities gnd less choice in the health insurdnce market a11 lead to increased hsk of being uninsured. underinlured or having less stable health insurance coverage. Rural America (a\ higher rates of uninsured dultc under 65. with 23 pcrccnt of uch rural adults unlnjured compared to 22 percent in urban arcas. The gaps grow wider in rur;ll areas that are not adjacent $ urban areas and in Inore remote dnd smaller rural areas. Thcse are a11 issues a public t)ealth insurance plan option would address. a11 to the bencfit of' rural individuals. families and businesses. ; Key points: The cost of health insurance is the self-employed and microbusinesses that form the bulk O f [he rural econolny. The 3V3i13bilitY Of affOrd3bIe ;Ind quality health insurance is the bmier to entrepreneurship - the most cffcctive rural dcvcl. opment strategy - reaching its potential for rural people and rural

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Individuiil and business mandates with the current system as thC

only health insurance option are unlikely to ;iddre\\ unique ruriil challenges. Workplace characteristics more common in rural arcas are risk f'actors for higher rates of uninsurance. underinsurance and greater dependence on the individual insurance market. conditions a11 subject to issues of' cost, choice and level of coverage that a puhlic health insurance plan could addrcss. A public health insurance plan available as an option helps address the rural risk factors leading to rural insurance instability and would act as a backup for all of the rural factors leading to greater insurance instability. A public health insurance plan could lead to significantly lower costs for businesses and households. Models show public health insurance plan premiums would be 16 to 30 percent lower than private plans. and premium savings would be up to 41 percent greater with a public health insurance plan. "It seems folly to depend solely on the current system that does not work for large numhers of rural people." added Bailey. "The cost of health insurance also affects the dreams of potential rural entrepreneurs. delaying or killing an idea by making it too risky for one to leave employer-provided in\urance at a current job. the so-called 'job lock' phenomena." This is the fifth in a series of Center for Rural Affairs reports examining crucial health care issues in rural America. Previous reports can be found on the front page of the center's website (www.cfra.org). The Center for Rural Affairs, established in 1973 as an unaf'filiated nonprofit corporation. was formed by rural Nebraskans concerned about family farms ; ~ n d rural communities.

Q 2009 REPUBLICAN~LEADER All Rlghts Reserved

Account: 18209C (25457) MN~285

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