Small NPOs Want Action on Healthcare

Small nonprofits want government action on health care, but they’re split over whether a “Medicare for All”-style policy is the right answer. The biggest motivation, according to survey results, is ensuring their employees have access to a quality health benefit.

It is a key finding from the Nonprofits on Benefits: 2019 Report from PeopleKeep. It draws on survey responses and other data from more than 100 nonprofits and religious organizations.
While nonprofit leaders consider it important to offer health benefits, many struggle to do so. The report found that more than 80 percent of small nonprofits can’t afford group health insurance. Another 52 percent responded that employees have diverse needs that make offering group health insurance difficult.
Many nonprofits are instead turning to the qualified small employer health reimbursement arrangement (QSEHRA), which allows reimbursement to employees, tax-free, for medical expenses.
Still, nonprofit managers would like to see additional health benefits options. Some 68 percent of those surveyed said they wanted to see action from the federal government to expand options outside of group health.
When it comes to Medicare for All, nonprofits are less certain. One-third of survey respondents expressed support for the policy, but 26 percent said they were opposed.

    Additional report findings include:

  • The biggest challenges to offering health benefits among nonprofits were cost (81%), diverse employee needs (52%), time (35%), and unpredictable revenue streams (27%).
  • Among nonprofits, arts organizations and social welfare groups were most supportive of Medicare for All (with 57% and 55% expressing support, respectively). Religious organizations were the least supportive, with only 15 percent approval.
  • Nonprofits suggested more control over prescription drug cost and more HRA options as ways the government might improve health care.