I am a small business owner and I’m scared.
If the Affordable Care Act is replaced, our family’s health insurance is likely to become even less affordable. My wife and I each own a small business. Provisions in the replacement bills may force either my wife or me to shut our business and find employment with less costly large-group health insurance.
Our family earns just enough that we are ineligible for subsidies. About one-third of our income goes to pay for health insurance and related costs. The proposed ACA replacements will allow insurers to raise premiums for older workers like me, which could make the cost unbearable.
But I fear that it could get much worse. Despite arguments from the opposition, the ACA was very well thought out. It imposed an individual mandate so that everyone, especially the young and healthy, would pay into the system so they could have affordable coverage when they become older or less healthy. The proposed legislation eliminates the mandate. Folks may then put off purchasing insurance until they are more likely to need it, which will increase premium costs for those with coverage.
Because “more affordable” health insurance is tied to larger-group employment, the ability to grow my small business is severely limited. A few years back, I was in discussions with someone I considered a potential dream business partner. But there was no way that my small business could afford to find coverage to match what he received from his current (larger) employer. And so I lost this opportunity.
As a business owner, I understand the power of the free market. My business, Boulder Bicycle, is engaged in a constant struggle against larger mail-order companies that aggressively compete on price. But the current repeal measures do nothing to harness market power. There is nothing in the repeal effort to increase price transparency and no new mechanisms to empower health consumers to seek out less costly providers.
I constantly ask myself: Do my customers get a good value for their hard-earned money? Based on what they tell me, I believe that they do. Can I say that about my family’s health care expenditures? Not even close. I’m paying into a system that consumes roughly 17 percent of our nation’s GDP. But in Japan, which has a relatively older population, the share is about 10 percent.
I hope for the day when a health care system emerges in our country that takes care of everyone. Currently we pay too much and we get too little. And many folks have no access to care at all.
I dream of a single-payer system focused on providing health care rather than creating profits. In the meantime, I hope that our legislators preserve the ACA and the gains we’ve made so far. My family, my community, and my business depend on it.