Small business prescription for national healthcare reform:
A summary
Read our detailed policy positions:
- General (PDF)
- Cost containment (PDF)
- Insurance reform (PDF)
- Design of a health insurance exchange (PDF)
- Tax equity for the self-employed (PDF)
- Benefit design in national health reform (PDF)
What small business needs
- Cost containment: Reduce costs throughout the system and level the playing field
- Choice: Create more coverage choices for businesses and employees, and make the healthcare system more competitive
- Convenience: Simplify the system for busy small business owners
- Coverage: Guarantee affordable healthcare coverage for all Americans
How we should tackle this
We need comprehensive reform; piecemeal solutions will not be sufficient to fix the current healthcare crisis. Specific initiatives should be based on these principles:
We need comprehensive reform; piecemeal solutions will not be sufficient to fix the current healthcare crisis. Specific initiatives should be based on these principles:
- Build on the existing private healthcare delivery and insurance system so people can keep the coverage they have if they want.
- Ensure that healthy competition and realigned financial incentives drive improvements, spur innovation and ensure high-quality, affordable care for all.
- Design a healthcare system that is economically sustainable.
Healthcare policy solutions
- Initiatives that contain costs, improve quality and increase value:
- Infrastructure: expanded use of health IT and research about what works in medicine
- Transparency and public reporting of costs and quality
- Incentives for expanded use of preventive services, primary care, and effective management of chronic conditions
- Malpractice reform
- Reduction in waste, fraud and abuse
- Tax equity for the self-employed that allows the full deduction of health insurance premiums for the purposes of their income tax and self-employment tax
- Insurance reform, including
- Guaranteed availability of coverage (no medical screening)
- No exclusion of coverage for pre-existing health conditions
- Health insurance rating rules that prohibit adjustments for health status
- A requirement that everyone have health insurance for a minimum defined set of affordable health benefits—with a provision that financial assistance be offered to people who can’t afford the cost of coverage
- A health insurance connector or exchange that pools small business buying power, offers health plan choices to employees, and relieves small business owners of the burden of administering health benefits
- Financing based on the principle of shared responsibility—including strong incentives and support for employers to offer affordable, high-quality health insurance. If the final legislation does involve a requirement that employers provide insurance or pay a fee, it must include some or all of the following provisions: a tax credit to help small businesses that couldn’t otherwise afford to offer coverage, a phase-in period for startup companies, a sliding scale based on payroll or number of employees and an exemption for the smallest businesses.
Healthcare reform can
save $29.2 billion in
small business profits
that would be lost to
rising health premiums over the next ten years,
a 56% savings.
