Policy Recommendations: Quality Jobs

Small Business Majority

Expand access to quality affordable health coverage

  • Make permanent the premium assistance provided by the Inflation Reduction Act.  
  • Allow individuals who reside in states that have not expanded Medicaid to purchase health coverage with premium assistance in the federal marketplace.  
  • Provide access to the full range of reproductive healthcare for women entrepreneurs and their employees.  
  • Lower Medicare age criteria to include individuals ages 55 and older.  
  • Strictly limit health plans that do not have the same coverage standards as those in the Affordable Care Act (ACA), such as short-term plans and association health plans. 
  • Allow employees who are offered employer-sponsored insurance to instead opt to receive premium assistance for marketplace coverage.  
  • Calculate marketplace premium tax credits based on the cost of a gold-level plan (80% actuarial level) instead of a silver-plan (70% actuarial level). 

Advance healthcare cost containment by tackling anti-competitive medical provider consolidation and abusive hospital and drug pricing

  • Block hospital mergers and acquisitions and ensure vertical integration between hospitals and physicians is done to improve patient outcomes, not to bolster profits and market power.  
  • Prohibit anti-competitive hospital contracting practices with insurance companies, such as large hospital chains using their market power to force insurance companies to include certain high-cost providers in their networks.  
  • Ban predatory billing practices that are not disclosed and justified.  
  • Create a cost commission to set reasonable hospital reimbursement rates based on quality and outcomes.  
  • Extend Medicare pharmaceutical drug inflation rebates under the Inflation Reduction Act to the private market, which penalizes drug manufacturers for raising prices faster than inflation. 

Foster access to affordable quality childcare for entrepreneurs and their employees

  • Implement policies that would help more working parents afford childcare by improving tax credits for childcare expenses.  
  • Reinstate recently expired federal subsidies for childcare providers via the Child Care Stabilization Act.
  • Support the creation and enactment of a federal incentive plan to create more childcare provider options to address childcare deserts.  
  • Enact legislation to drive investment into childcare businesses through efforts like the Small Business Child Care Investment Act.

Provide access to portable benefits, including family/medical leave and retirement

  • Establish a national program that would provide partial wage replacement for small business owners, employees and the self-employed to access paid family and medical leave. 
  • Implement a federally sponsored retirement program to complement successful state programs covering those who are not able to access employer-sponsored plans. 
  • Ensure that all small business benefits are available to self-employed entrepreneurs. 

Expand workforce opportunities, including those for immigrants and justice-impacted entrepreneurs

  • Enact comprehensive immigration reform. Short of that, reinstate the Deferred Action for Childhood Arrivals (DACA) program. 
  • Expedite and improve temporary work visas. 
  • Implement Fresh Start Reform measures, which would limit disqualifications for occupational licensing, giving justice-impacted individuals the ability to secure licenses for work. 
  • End debt-based driver’s license suspensions, which disproportionately harm people of color and prohibit employees from traveling to work or even applying for jobs.
  • Advance Clean Slate policies to ensure that small businesses can tap into an underutilized workforce composed of justice-impacted individuals who have remained crime-free for non-sexual and non-violent crimes.  
  • Include immigrants and justice impacted individuals in any effort to reauthorize the Workforce Innovation and Opportunity Act (WIOA).