Seven years into Obamacare, small business owners across the Midwest say health insurance still costs too much and they struggle to find affordable plans for their workers. Plus, they remain stumped over what federal health reform offers them: an online exchange geared toward business owners.
That's according to a new survey jointly conducted by the Chicago-based Women's Business Development Center and the Chicago nonprofit Health & Disability Advocates. They queried small business owners in five Midwestern states, including Illinois, just after the November election. The goal was to get employers' perspectives on offering health insurance, wellness initiatives and the impact of the Affordable Care Act, known as Obamacare.
"If the new ideas percolating in Congress are going to have any success, we need to be looking at small businesses and making them somewhat of a focal point," said Barbara Otto, CEO of Health & Disability Advocates. "They really are the economic engines of our economy."
The survey comes at a time of immense uncertainty over how President Donald Trump plans to unravel his predecessor's landmark health reform law and if pieces popular even among his voters will remain intact. Everyone from patients to doctors and employers are in an anxious wait-and-see mode, hoping the nation's leader and Republican lawmakers doesn't cause too much disruption to a law that has insured more than 20 million people.
Small businesses owners are on edge too. These employers, defined by the U.S. Small Business Administration as having fewer than 500 workers, make up the bulk of businesses nationwide. At least half in 2012 were owned by women, the most recent data from the federal SBA shows.
The survey received responses from 147 women-certified businesses, which are no fewer than 51 percent owned, managed or controlled by women.
Among the key findings:
• Only 53 percent of employers with fewer than 50 workers offered health insurance in 2016 compared to 96 percent of businesses with at least 100 employees.
• More than half of respondents said costs were a main barrier to offering coverage;
• While many respondents knew little about being able to buy health plans for their workers on the public health insurance exchange created under Obamacare, they supported certain provisions of the law. That includes requiring insurers to cover everyone regardless of whether they have a pre-existing condition like diabetes. These types of mandates help small businesses attract talent, respondents said;
• They support changes to the law, such as making it easier for small employers to apply for a tax credit they can use to purchase health plans for their workers.
"Without affordable accessible to health care, that could discourage the formation of businesses, which would have a significant impact on our economy," said Emilia DiMenco, president and CEO of the Women's Business Development Center.
Most small business owners have stuck with brokers to offer health plans for their workers. Obamacare created a public health insurance exchange for consumers and small business owners alike. But confusion, a lack of options (only two insurers for small employers to choose from) and steep prices dampened chances for businesses that the online marketplace would take off, at least in Illinois.
Small employers who responded to the survey said they wanted more communication about the benefits of Obamacare. It's not clear what kind of promotion for the exchange exists. Michael Batkins, a spokesman for the Illinois Department of Insurance, said marketing falls to the federal Centers for Medicare & Medicaid Services, which oversees the online marketplace. CMS spokesman Aaron Albright referred back to Illinois insurance regulators.
"Small business to Trump: Let us help revamp Obamacare" originally appeared in Crain's Chicago Business.