To the Editor:

When President Obama recently mentioned that one big insurer controlled 96 percent of the market in a just one state, a collective (and very loud) gulp went down the throats of insurance industry executives. You see, this domination of the small group market, where small businesses are forced to buy insurance, drives costs up at an unsustainable rate.

So, the secret is out, but the question is — will the insurers fess up. As the state director of the National Federation of Independent Business/West Virginia, I hear first-hand from small business owners about their ever-increasing costs and lack of choices. But, the proof is in the pudding, or in this case the Government Accountability Office’s research.

According to the GAO (February 2009), 86 percent of West Virginia’s small group health insurance market is controlled by five large insurers, with Mountain State Blue Cross Blue Shield writing 52 percent of all policies in the state.

Yes, there are 1,300 health insurance providers in the United States, but the vast majority of them aren’t doing business in West Virginia

Why not? Because state-regulated healthcare for small business has become a virtual monopoly for big insurance. Small business owners and their employees have been crushed under this model, while companies like Blue Cross and a few others have flourished under it.

We are in new times, however.

Congress is considering reforms that would allow small businesses to shop for health insurance like each of us buys our car insurance and groceries. A transparent exchange would spur badly needed competition, help contain rising costs, increase pool size and keep big insurance honest.

I urge your readers to encourage our members of Congress to make meaningful market-based healthcare reform a reality.