Healthcare

Executive Summary

More than any other sector of the economy, small business suffers from our broken healthcare system. From spiraling premium costs to inadequate access to quality healthcare for themselves and their employees, small business owners have seen their prospects for growth diminished and their profits slashed by today's patchwork of inefficient healthcare options.

When the Affordable Care Act was signed into law in 2010, it delivered sweeping reform to the nation’s healthcare system. A significant feature of the law is an expansion of Medicaid to cover a larger number of low-income individuals. In June 2012, the Supreme Court ruled it was up to each state to decide whether to expand eligibility for Medicaid. Medicaid expansion gives every state the opportunity to take advantage of federal funding that will support jobs and stimulate economic growth while expanding health coverage.

When the Affordable Care Act was signed into law in 2010, it delivered sweeping reform to the nation’s healthcare system. A significant feature of the law is an expansion of Medicaid to cover a larger number of low-income individuals. In June 2012, the Supreme Court ruled it was up to each state to decide whether to expand eligibility for Medicaid. The Medicaid expansion gives every state the opportunity to take advantage of federal funding that will support jobs and stimulate economic growth throughout the state while expanding health coverage for its residents.

On June 12, 2012, Small Business Majority and Kaiser Permanente released opinion polling that provides new insight into what small business owners in California and Oregon want out of state health insurance exchanges, which are being created under the Affordable Care Act. The polling found interest in a small business exchange is high, along with specific features in the exchange, including allowing employees to choose among multiple carriers and ensuring prevention and wellness programs are available. The survey also found awareness of the small business tax credits is low.

Congress included in the Affordable Care Act a significant new tax credit for small business owners who provide their workers with health insurance. Under this new tax credit, businesses that have fewer than 25 full-time workers and average wages of less than $50,000 are now eligible to receive a tax credit of up to 35% of the cost of the health insurance that they provide for their workers.

Small Business Majority released a national survey of 619 small business owners in January 2011 to gauge how entrepreneurs view two critical components of the Patient Protection and Affordable Care Act: healthcare tax credits and insurance exchanges.

Small businesses are the backbone of America’s economy. Across the country, there are nearly 4.8 million businesses that employ 25 or fewer workers. They’re your local diner, the hardware store down the street, and the mechanic in your neighborhood. 

Congress included in the Affordable Care Act a significant new tax credit for small business owners who provide their workers with health insurance. Under this new tax credit, businesses that have fewer than 25 full-time workers and average wages of less than $50,000 are now eligible to receive a tax credit of up to 35% of the cost of the health insurance that they provide for their workers.

Although large employers have been expanding wellness programs in recent years, small businesses have lagged in this endeavor. Since small businesses employ nearly 50% of all private-sector workers, any comprehensive expansion of wellness and prevention efforts must include a role for this large swath of private sector employers.

The Supreme Court is expected to hand down its decision any day in the case against the Affordable Care Act, filed by the National Federation of Independent Business (NFIB) and state attorneys general. The polling of 800 small business owners in eight states (Florida, Illinois, Louisiana, Michigan, Missouri, New York, Texas and Virginia) found 50% of small business owners want the healthcare reform law upheld—either as is or with minor changes—while only one-third want the Supreme Court to overturn it.