A new study finds that 49% of U.S. workers in small businesses were offered health insurance in 2010, down from 58% in 2003.
Firms with 100 or more employees were far more likely to provide health benefits, at 90% in both 2003 and 2010, according to the report from the Commonwealth Fund, a private foundation that does healthcare research.
Low-wage workers in small businesses were the least likely to be offered coverage: One-third of workers making less than $15 an hour in small firms were able to enroll in their employer's health plan.
Other findings included that 45% of small-business workers reported difficulty paying medical bills in 2010, and 46% said they skipped needed medical care because they couldn't afford it.
The federal healthcare law seeks to address some of these problems by offering premium tax credits to certain small businesses and, starting in 2014, by granting subsidies to many uninsured workers toward their purchase of health insurance.
The California Health Benefit Exchange, renamed Covered California earlier this week, is developing an online marketplace for individuals and small employers where insurers will compete for their business.
The average premium for employer coverage in California has increased 154% over the last decade, more than five times the 29% increase in the state's overall inflation rate.
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