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Virginia Healthy Small Business Initiative


The purpose of the Virginia Healthy Small Business Initiative is to expand small business health coverage by market-testing a three-share health plan which will be supplemented by a wellness program for employees and their children, and promoted with a rigorous outreach and education strategy. This project will test the innovation of expanding small business health coverage by offering affordable health coverage products, emphasizing wellness, and explicitly demonstrating linkages between employee health, employee productivity, and business profitability.

The Virginia Healthy Small Business Initiative builds upon nearly two decades of incremental but forward-moving health care reform in Virginia that began in the 1990s. It also builds upon the recommendations from three major policy research and planning initiatives that began 2003: Virginia’s State Planning Grant, Virginia Commission on Small Business Health Insurance Costs, and the Governor’s Health Reform Commission. With the multi-year support of the State Planning Grant Program, Virginia undertook a statewide, collaborative effort to develop a plan for expanding health coverage for the working uninsured, culminating in recommendations to establish a three-share health insurance product for low-income workers called Virginia Share, and a Center for Health Coverage Education to help Virginia individuals and small businesses better understand health coverage.

These recommendations were consistent with the findings of the Virginia Commission on Small Business Health Insurance Costs (2004), and were further highlighted by the Governor’s Health Reform Commission (2007). Although Virginia has been unable to implement either option due to the subsequent severe downturn in state revenues, the private sector has stepped forward to keep both initiatives alive in a limited form. Virginia proposes to revitalize and substantially extend the work started through the Virginia State Planning Grant Program with an integrated strategy of health product innovation and small business outreach and education.

The anticipated accomplishments include:

  • To increase the number of small firms in Virginia who offer health insurance and wellness programming to  their employees. 
  • To increase the number of workers in small firms with household incomes less than 400 percent FPL who  enroll in health coverage and wellness programs. 
  • To create a paradigm shift among small firms in Virginia regarding the value of employee health and health coverage to their overall business development strategy.
  • To inform decision making about the structure of the health insurance exchange, the dynamics of benefit structure and actual utilization of services, and potential interest in wellness programming among individuals and small employers as Virginia prepares for implementation of health care reform.

The proposed plan is expected to have a substantial positive impact on providing access to affordable health care coverage to the proposed segment of the uninsured population because, if successful, it will create a paradigm shift among employers regarding the importance of employee health and health coverage. A transformation in the thinking of this hard to reach population is necessary in order to stem the tide of erosion of ESI that has taken place in the Commonwealth since 2001.


Last Updated: 03-27-2014

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