Health Coverage Taking Center Stage for U.S. Small Businesses

It’s safe to assume most small-business owners understand the implications—both positive and negative—regarding whether to include employer-subsidized healthcare benefits as part of their compensation packages.

At its most basic level the debate pits the bottom-line economic impacts of an employer offering healthcare coverage versus the ways in which not offering coverage would adversely affect the company’s ability to attract the level of talent required to remain competitive.

During my career I’ve experienced both extremes—from 100 percent employer-paid coverage to nonexistent coverage—as well as having worked for one employer that provided a monthly stipend to help offset the cost of my chosen health insurance.

But for small-business owners, 2014 marks the point at which the federal Patient Protection and Affordable Care Act (abbreviated: Affordable Care Act, or ACA) mandates they must offer employer-subsidized coverage or face penalties. (Oddly, the ACA defines any business with 50 or more full-time equivalent (FTE) employees as a “large” business, which contradicts the generally accepted definition set forth by the U.S. Small Business Administration, which states that in most cases any company with fewer than 500 FTE employees is considered a small business.)

For the truly “small” businesses (as defined by the ACA’s less-than-50-FTE-employee threshold), a piece of the 2010 healthcare law intended to assist with providing employer-subsidized health insurance to their employees will be delayed by one year.

According to a recent Washington Post article, “The office in charge of Medicaid and Medicare announced that it was on track for an Oct. 1 launch of the federal SHOP Exchange, an online marketplace where companies with fewer than 50 employees would be able to buy insurance for their workers and get a tax credit.

“But employees will not be able to choose from a variety of plans, as was initially expected. They will be able to choose only one plan. The full range of options will not be available until 2015, the agency said.”

Regardless of when the various phases of the ACA are enacted, and to what extent the intended scope of each phase remains intact, clearly the new law will affect a very large segment of this country’s economic contributors. As to whether those effects prove positive or negative, opinions abound, but only time will tell.

To me, one thing’s clear: It’s tough to research the ins and outs of the ACA without feeling lost. There’s simply so much to wrap one’s mind around. Which is why if I were a small-business owner I’d be relieved to find an assortment of readily available resources to help explain the minutiae, including “The Healthcare Playbook: A Small Business Guide to PPACA,” courtesy of the National Federation of Independent Business. The guide provides a helpful overview of the ways in which the new law currently impacts small businesses, and what steps need to be taken to ensure compliance going forward.

Additionally, Kaiser Health News offers a treasure trove of timely articles covering every healthcare-related topic, including plenty of chatter about the ACA.

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  1. Robin June 21, 2013 - Reply

    We can only hope that business will tire of trying to decode more legislation put upon them and begin to lobby for government sponsored single payer insurance.

    • Nathan Van Ness June 21, 2013 - Reply

      Robin, while remaining politically agnostic in this debate, I really appreciate you taking the time to read the article and share your thoughtful feedback. Thank you.

  2. Seth June 21, 2013 - Reply

    Beginning of the end for employer-directed healthcare, a day that can come none-too-soon

  3. Nathan Van Ness June 21, 2013 - Reply

    Seth: That’s a debate for another day, but I appreciate your comment nonetheless.

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