
When I was a non-profit executive director (yes, I was) the absolute WORST, bar none, part of my job was the annual negotiation of the health insurance package. Now, my agency actually had - woo hoo - six, count e'm, six employees paid to work 30 hours a week who could thus qualify to be on our plan. I know many, many non-profits who have far fewer than that. Our group, however, was so small that our rates were astronomically high. You see the law in the State of Connecticut essentially required any insurance company that wished to sell health insurance in CT to offer small group policies. Sounds good, right? Wrong! The giveback to the industry was that the small group rates were set by the Insurance Commissioner, and so there was no meaningful competition. Every year I would have our agent shop around, and every year the rates were within pennies of each other. And, the increases from year to year were huge: 22% one year, 15% the next, 20% the next, etc. My employees complained bitterly, especially since the agency could not afford to contribute much to the cost. The staff bore the full brunt, essentially. At one point, I had a staff member who was paying over $900/mo for a family plan WITH A $10,000 OUT OF POCKET DEDUCTIBLE. Her take home was around $400/mo after insurance. Her family basically had to pay $20,000 a year before anything was covered. And this was five years ago. Can you imagine what it would be now?
I've been listening a little to the healthcare debate, and rarely does this issue come up. People talk about employer-based insurance a lot, and they either don't realize or don't seem to care that many, many non-profit employees don't have ANY option from their employers, because the agency is too small and/or too poor to offer it. Many non-profits treat their staff as contractors for this reason. Giving tax breaks for offering health insurance doesn't apply to non-profits either.
So, whatever side of the debate you're on, just remember that there is a significant and very valuable component of our society out there - the non-profit workforce - that I suspect is very underserved by the health care system. Remember them, and let's see what we can do to help them.