Senate health bill gives small businesses a splitting headache

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Washington has been abuzz about a secret plan that was finally revealed this week — the Senate Republicans’ bill to repeal the Affordable Care Act (ACA). In all the noise surrounding its rollout, we can’t forget about a critical constituency — America’s small businesses.

While repeal of the ACA would be bad for citizens across our country, it would be even worse for those in the business community who have spent valuable time planning and implementing the health care law. Any business owner will tell you that uncertainty can wreak havoc. We need our entrepreneurs to feel confident enough for them to invest in the economy, and if the current bill is passed into law, it will cause the type of confusion that is bad for the market and a hindrance to growth. 

{mosads}In the seven years since the ACA was passed, the business community has already devoted significant time and resources into understanding their options under the law, and many are already benefiting from it. In fact, the ACA brought new healthcare choices to millions of people.


In January, the U.S. Treasury Department and the Department of Health and Human Services released a report showing that one out of five customers benefitting from the marketplace in 2014 were small business owners or self-employed. This report is evidence that the ACA marketplaces have given entrepreneurs a place to shop and compare health insurance plans, an option many business owners did not have before.

Even more importantly, because people aren’t as reliant on employer insurance for their health care coverage, the ACA encourages entrepreneurship and inspires new businesses to start. Repealing the law and replacing it with the Senate’s bill could very well take away the coverage that many small business owners rely on, putting their venture in jeopardy. 

That’s why we recently hosted a call with about 200 small business owners to talk about what is going on in Congress with healthcare. The call featured Andy Slavitt, who was the former head of the Center for Medicare and Medicaid Services. Many small business owners on the call were concerned about the tumultuous time ahead if the Affordable Care Act is repealed — a return to spiking, unpredictable premiums year to year and, for many, inadequate health care that failed to cover or limited important medical needs.

One of the business owners who joined us, Kelly Conklin, has owned architectural woodworking firm Foley-Waite Associates in New Jersey for 30 years. He shared his story, one that is familiar to many small business owners across the country. For small business owners, the costs of health insurance is not limited to money. The time and energy required to find, understand, register and administer plans can divert significant resources away from business growth.

Before the ACA, Kelly saw such sharp premium increases year to year that he was forced to spend weeks at a time “shopping” for health insurance for himself, his family and his employees, in an effort to keep the cost under control. Often, the options available to him as a small business owner, including association health plans, were high cost for little care — choices that no small business owner wants to make.

Under the ACA, premium increases have stabilized and essential health benefits allow Kelly to invest far less time in administering health insurance plans and far more time, energy and money into growing his business. 

One of the most important things President Trump and Congress can do right now is put partisanship aside and work across the aisle to improve the ACA. For example, one great provision is a tax credit that has helped small businesses with fewer than 25 employees afford high quality health care coverage.

While the tax credit has been helpful to many business owners, there is more that can be done. The current Senate bill threatens this provision by ending the tax credit in 2020. We believe there is a bipartisan opportunity to enact an expansion that would help more small businesses qualify and provide coverage for their employees.

The ACA is already helping many of our country’s entrepreneurs and providing health insurance to millions of people. For our nation and its 29 million small-business job creators, repeal and replace will only take us backward. We need to focus on solutions that will take us forward.

Rhett Buttle is the founder of Public Private Strategies, a consulting firm with a focus on where the public and private sector meet. Previously, he was the business director for Hillary Clinton’s 2016 presidential campaign and an appointee on The White House Business Council and the director of private sector engagement in the Office of the HHS Secretary from 2014-2016, where he worked on the implementation of the Affordable Care Act (ACA). Follow him on Twitter @rhettbuttle.

Amanda Ballantyne is the national director of the Main Street Alliance, a national network of state-based small business organizations. Follow her on Twitter @mainstreetweets.

The views expressed by contributors are their own and not the views of The Hill.

Tags Health insurance marketplace Healthcare reform in the United States Hillary Clinton Medicaid Medicare Provisions of the Patient Protection and Affordable Care Act
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