The Affordable Care Act (ACA) – also known as Obamacare – was not the perfect solution to the nation’s need for affordable healthcare, but it did increase the availability of quality, affordable healthcare for small businesses. Companies that had struggled for years – not only to find affordable health insurance for their workers but also to negotiate double-digit premium increases every year – were relieved to have choices and manageable premium rate increases. Following Trump’s inauguration, Republican attempts to repeal the ACA without providing an alternative solution recreated the nightmare for many small firms. The administration’s ultimate failure to kill Obamacare ended up being a relief for many entrepreneurs and small business owners, but many issues remain unresolved.
Business owners see the need for a bipartisan effort to develop realistic and affordable solutions, which would enable the small business sector to thrive and continue to fuel our nation’s economic growth. Here are some of the concerns that leaders have identified:
- A recent report from the Congressional Budget Office on the fiscal impact of the Federal government yanking the cost-sharing subsidies that support the ACA marketplaces (a revision that would most likely occur if Republicans continue to gut the ACA) suggests that insurance premiums for small businesses would increase an average of 20 percent next year growing to a 25 percent increase by 2020. Although the Federal government is required by current laws to pay these subsidies, President Trump has indicated he wants to stop these subsidies by any means possible as part of his mission to dismantle the ACA. The CBO has calculated that the potential economic impact on the federal deficit could be as much as $194 billion, because a move like this would require consumers to obtain additional tax credits to offset their premium payments.
- The elimination of cost-sharing subsidies would likely lead many insurance companies to exit the individual insurance market, and could disrupt the health insurance marketplace and leave small business owners with limited access to affordable health insurance options.
- Small business advocates oppose the introduction of any measures that would result in separate risk pools for the healthy and the sick, and want to see measures to encourage businesses to establish association health plans.
- Sector leaders want to see steps taken to expand Medicaid. ACA already had provided coverage to an additional 14 million previously uninsured Americans – a total that includes an estimated 2 million small business employees.
- Entrepreneurs want to see healthcare tax equity measures in place for the self-employed to allow them to deduct healthcare expenses from FICA tax obligations.
The small business segment is hailed as the champion of job-creation in the United States. If it is to continue in this vital role, lawmakers must expand efforts to do more to reform healthcare insurance.