Small Business Owners’ Views on Implementing the Affordable Care Act

Small Business Majority
Thursday, June 14, 2012

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. Once small business owners learn more about the law, their support for keeping it intact—either as is or with minor changes—rises to 56 percent, while opposition falls to just 28 percent.

Key Findings

Only a third of small business owners want the Supreme Court to overturn the Affordable Care Act; a plurality of 50% would like it upheld, with minor or no changes. This support grows after learning more details about the law’s key provisions: Only 34% of small businesses want to see the healthcare law overturned, while 50% want it to remain intact with, at most, minor changes. After learning more about its specifics, only 28% want to see it repealed and a 56% majority want it to be kept, as is or with minor changes. A 55% majority say they want it upheld because we need to make sure everyone has health coverage.

After learning about the law, support for the Affordable Care Act grows

There has been a lot of talk about the nation's health care reform law, the Patient Protection and Affordable Care Act. Which one of the following statements comes closest to your point of view when it comes to this law.

After everything you read, which one of the following statements comes closest to your point of view when it comes to the nation's healthcare reform law, the Patient Protection and Affordable Care Act.

By an 8:1 margin, entrepreneurs say they’d consider using a state health insurance exchange, and they favorably view many possible features of the exchange:
A 66% majority of small business owners say they would use their state exchange or at least consider using it, compared to 8% who say they would not consider using it when they provide benefits. By wide margins, entrepreneurs find a host of possible features of the exchange very appealing. By a 2:1 ratio, small business owners support their state applying for federal funds to set one up.

The majority of small businesses would consider using a health insurance exchange—online marketplaces being created under the Affordable Care Act—to purchase insurance in 2014

Do you think that in 2014 you would use the exchange to provide your employees with health insurance benefits, consider using the exchange, obtain health benefits for your employees from another source, or would you not pay for health benefits for your employees?

A vast majority of respondents support a host of additional provisions in the law, such as preexisting condition exclusion bans, medical loss ratio and rate review: Nearly 8 in 10 owners support prohibiting health plans from denying coverage based on preexisting conditions, 72% support requiring insurance companies to spend at least 80% of small group premiums on patient care and quality improvement (as opposed to plan administration, marketing and profits) and 65% support allowing states to review and potentially reject excessive premium rate increases.

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