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Jody Miller

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Small Business Needs Obamacare

Posted: 03/23/2012 8:24 am

Before we're overrun by dueling constitutional lawyers, can one entrepreneur please weigh in on the fate of the president's health care law? Because lost in the political and judicial feud is a little known fact: small businesses are placed at a fundamental competitive disadvantage today by the way America's health care system favors large employers. The Affordable Care Act fixes this. For small firms, Obamacare's survival is therefore central to their own.

I know this from personal experience. I founded a firm several years ago that's a market leader in the new field of supplying high-end project professionals on demand to the Fortune 1000. Our firm has created 25 high wage American jobs to date, and we expect to create dozens more as we grow. Yet my business -- precisely the kind of small, growing firm that politicians hail as the source of most new job creation in America -- is now at risk because we can't arrange health coverage for key employees.

Like many scrappy start ups, my company decided that providing health care wasn't practical at the outset -- it was expensive, as well as a distraction from the essential work of proving out our business model. As we've established ourselves, however, it's become clear that to compete for the best talent we need to include health care in our offer, because great people have big company alternatives where such coverage is the norm. In every other wealthy nation, of course, this burden is not placed on employers -- the government makes sure individuals can acquire group insurance coverage directly, either via private insurers (as in Holland and Switzerland), state run pools (as in Canada or the UK), or some hybrid.

Let's stipulate that it's crazy in the 21st century to make employers responsible for this central social welfare function. As long as that's the norm in America, however, at some point a firm like mine seeks to evolve past a situation in which most of our team arranged for health care on their own or via spouses or parents who had coverage from larger firms. We're generating enough cash to offer health care ourselves. That's where the trouble comes in.

My company expanded quickly, and now has employees spread out in California, New York and Texas. There are only a few national insurers who offer small group coverage to firms like ours, because of the complexity and hassle of state-based underwriting rules. Only one of those would even take an application from us. That firm turned us down the other day because, while our team is relatively young and healthy, some of our employees were deemed to have pre-existing conditions. As a result, we may now lose key employees who obviously can't go without the health security a much larger company's risk pool can guarantee.

It should be obvious to every capitalist that this state of affairs is bad for entrepreneurship, bad for innovation, and thus bad for the economy. The hopeful news, which I only learned once we were denied coverage, is that the state insurance exchanges established by President Obama's health reform will offer a solution for firms like ours. We could access these exchanges as a small firm with fewer than 50 employees, or our employees could access them directly. But not until they open for business in 2014. Our first thought was: maybe we can patch together some solutions for our key people until then. That is, if the Supreme Court doesn't overrule the whole thing.

Which brings me to the Republican presidential candidates. Every time they say they'll "repeal Obamacare on day one," I hear them saying "your company is doomed to being uncompetitive in the market for talent in perpetuity." Obamacare's exchanges solve this problem, just as Romneycare's (on which they were modeled) did in Massachusetts. This isn't about ideology or politics. It's about small firms' ability to recruit and retain employees in a country where the deck is already stacked senselessly in favor of big business.

Republican candidates like to sing the praises of entrepreneurs. But do they really want people like me spending our time figuring out health coverage instead of growing our businesses?

The brokers we've worked with say our only option at this point is to work any connections we have at the health plans to get our denials reversed. They make exceptions all the time, I'm told -- you just have to know someone. I'll do what it takes to protect my firm, but what kind of banana republic have we become when this is what's expected?

Mitt Romney deserves special scorn here. He knows all this. He fixed the problem in his state. He's just thinks it's too risky to explain it to Republican primary voters. If that's the way you want it, Mitt, fine. But then I need you to pick up the phone, call the CEO of Aetna or United Healthcare, and solve my problem.


Ms. Miller, based in Los Angeles, is co-founder and CEO of Business Talent Group.

 
 
 
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11:50 AM on 03/27/2012
Health care cost/insurance cost is a Clear and Present Danger to the economy of the United States.
oilfield
large employer per obamacare
01:22 AM on 03/26/2012
we once were able to pool together with other small businesses through payrolling services and get insurance together until it was made illegal....hmmmm i wonder why that was....and this bill still does nothing to help us get lower rates like the large companies.
04:50 AM on 03/25/2012
Move your company to a state that guarantees health insurance for small businesses.
12:39 AM on 03/25/2012
Why can't we all get the same rate as the Federal employees get? If all small businesses could get the government's rate, we could all afford health insurance for our employees.
09:51 PM on 03/24/2012
Only until we see jobs return to this country, and outpourings of wealth stop trickling abroad, can we afford to build a medical infrastructure, able to support the projectable influx of health care recipients in need w/o kicking over what remains of the already staggering business community.
Not drinking the ''cool aide.''
01:45 PM on 03/24/2012
It's already saved costs at some small businesses by forcing employers to increase co-payments so much that employees are forced to go without insurance altogether. Employer then pays nothing for them. All hail Obamacare!!!
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devondx
Totally De-regulate all RED states=JUSTICE..
01:35 PM on 03/24/2012
who needs US labor to compete in the world market ......?

just hire forign workers with socialized insurance from their government...problem solved !!

way to go GOP !!!...vote GOP Theocracy 2012 !!
02:38 AM on 03/25/2012
yep
01:26 PM on 03/24/2012
Start with the basics ... "universal" health care is supposed to cover everyone but in this case it exempts the very group who drafted and passed it.

And only this group has the authority to grant health care law waivers.

What other country with universal health care exempts the group that drafted and passed it ... NONE.
10:40 AM on 03/24/2012
I started a small business nearly 30 years ago and we have always had health insurance for our employees (never have had more than 25 employees and today less than 12). We get bids annually through an independent insurance agent. The cost to the company is about 4 percent of sales (or roughly half of the potential net profit we could make). So,why do we comtinue to carry it? Because of a feeling of responsibility toward our employees (I know that's unheard of today) and it helps keep a stable work force. However, I welcome the new healthcare program. It can be of great benefit to many small businesses including our own even though many small business owners I know have drunk the right wing kool- aid that lambasts the government program.
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John Galt2
My life is my own...
11:38 AM on 03/24/2012
Most businesses plan to dump their health plans if the PPACA as the premium cost savings will dwarf the minsicule (by comparison) tax penalties for not providing insurance.

That's the real goal of the PPACA - get the masses onto the exchanges and usher in single-payer once they decimate the private insurance industry (via pre-existing exclusion eliminations and tax penalties of only 2.5% max of AGI - far below the cost of annual coverage).

The PPACA is no friend of business or anyone else in the long run.
01:37 PM on 03/24/2012
You've hit the nail on the head. Execs have this option in their business plans and are ready to put it into action as soon as the supreme court ruling is handed down.
oilfield
large employer per obamacare
01:25 AM on 03/26/2012
we will probably have to dump eventually.....its way cheaper to pay the penalty. and the employees are subsidized to 10% of gross under 90k.....so they save too.
oilfield
large employer per obamacare
01:24 AM on 03/26/2012
so when the costs go to 7% or 8% what will you do?
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Juiceman1982
Don't hate me because I'm right
09:14 AM on 03/24/2012
The vast, vast majority of small businesses do not have employees spread out across the country so the author's situation is in the distinct minority - for this and other reasons. I don't know what state her home office is because I don't want to re-read the article but in Illinois, her group could not be turned down for coverage, no matter what the pre-existing conditions are. Basing her decision that ObamaCare is good for all small businesses because of her unique circumstances is faulty logic.
07:44 AM on 03/25/2012
I have the same business, and I have the same multi-state issue. There are reciprocal policies that she can get on a national scale through her current in-state provider.

This article is an argument for Obama-care to retain her profit, and also her dividend pay outs on that profit at the end of the year taxed at a lower rate than ordinary income. Poor planning has put her in this situation because once she offers benefits to one employee, she must offer them to the other 25 currently billing at a specified hourly rate with her customers. Her choices are to

1. Tell her customers that she has to increase her rates for all of her employees (not going to happen)
2. negotiate down their rate and offer them the benefits (nobody likes a pay cut)
3. lower her profit margin (not going to happen)
4. have a bunch of existing employees turn down coverage and not meet her enrollment % to qualify.

It is so grossly transparent, I am wondering why people are in her corner. There are much better arguments to be made than this one, but the truth is that if she gets the exchange, she gets rid of a headache, doesn't have to make any tough business decisions and keeps more money in her pocket that will be taxed at a lower rate once paid out in a dividend.

Case study in an entrepreneur that didn't plan properly.
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Darius Molark
de gustibus non est disputandum
12:44 AM on 03/24/2012
The Affordable Care Act will turn out to be not only a god-sent blessing to your business, Ms Miller, and other small business owners, but fundamentally to those millions of the poor who do not have health care insurance. This is earthshaking as was the intro of Social Security and Medicare. It will be President Obama's and our greatest achievement.
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John Galt2
My life is my own...
11:39 AM on 03/24/2012
And it will prove to be every bit financially disastrous as SS, Medicare,and Medicaid as well...
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HUFFPOST SUPER USER
Darius Molark
de gustibus non est disputandum
12:22 PM on 03/24/2012
You set a goal, a direction. Then you make it work.
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devondx
Totally De-regulate all RED states=JUSTICE..
01:30 PM on 03/24/2012
its not the programs that were disasterous its the bush tax cuts, bank speculation

and the bush incompetency at war....not enough trops no securing

the Iraq infrastructure.....reality and the GOP theocracy don't mix ....

neither do blue states and red states......time to end the Union and move-on...

or back to the 1900s for the GOP.....No taxes , no regulation, lots of war...

have fun with that and c-ya....
oilfield
large employer per obamacare
01:26 AM on 03/26/2012
yes, we will lower our 5k current cost to the penalty rate of 1500.....
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HUFFPOST SUPER USER
Darius Molark
de gustibus non est disputandum
07:12 AM on 03/26/2012
You will do whatever you can to make it work. That's what it is about, fitting in under one massive coordination to find out what works best.
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CubnKira
12:36 AM on 03/24/2012
Obamacare is the main reason for businesses not hiring. It is a jobs killer. Why do you think so many businesses tried to get waivers? Most came from Pelosi's own district. Now, waivers are disallowed and businesses are not hiring in large part because of Obamascare.
10:50 AM on 03/24/2012
I wouldn't agree with that at all. The reason that small and large businesses are not hiring is they don't have increasing sales, so they don't need more people. If the public had more money to spend, sales would increase and businesses would hire, completely ignoring any minor changes in costs, assuming there are any.
oilfield
large employer per obamacare
01:27 AM on 03/26/2012
why would you need a waiver for a great govt program?
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morris111
fac fortia et patere
11:44 PM on 03/23/2012
Obamacare is the last thing my small business needs.
08:55 AM on 03/24/2012
Yeah, because you're too blinded by by your own hatred to see the benefits. You'd rather see your business burn to the ground than to admit Obama has the best interest of the country in mind.
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John Galt2
My life is my own...
11:40 AM on 03/24/2012
I don't believe morris111 is the one blinded...
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Robert Terry
10:45 PM on 03/23/2012
As a small business owner please repeal ooooobamacare as soon as possible. It will destory small business as it will large business. It is a train wreck waiting to happen.
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HUFFPOST SUPER USER
elgeezr
10:34 PM on 03/23/2012
Being a business founder I'm sure you will have no problem deciding what to do when this scenario comes true: In 2014 health insurance for your workers is costing you $18,500 per employee. Your annual cost is $185,00. Under Obamacare, if you decide to no longer pay these premiums, you can, but you must pay a fine. Turns out the fine is $1,000 per employee. Hmmmmm..... Now what should you do?
10:27 AM on 03/28/2012
Can you back those claims? Doesn't matter how many businesses you've founded, your math does not make since. "$18,000 per employee". "annual cost is 185.00." ? Care to elaborate?