OPINION: Obamacare’s help for small business

Introduction

With April 15 approaching, some small business owners who provide health coverage to their workers are not going to be as indebted to Uncle Sam as they have in years past, thanks to Obamacare. That’s right, thanks to Obamacare.

Mike Roach, owner of Paloma Clothing, a women’s clothing store in Portland, Oregon, is among them. He is one of several hundred thousand small employers who have taken advantage of a provision of the reform law that provides a substantial tax credit to companies that offer health insurance to their employees. And not only is Roach able to save money, now that he’s offering coverage, he’s no longer losing valued employees to large department stores that have long provided benefits as a recruitment tool.

Roach had always wanted to offer coverage to his 12 employees but had found the premiums too steep. He said the message he kept getting from insurance companies was, “We don’t really want your business, but we will do business with you as long as we can gouge you.”

Small businesses like his have always had to pay considerably more for the same coverage as large employers. At big companies with hundreds or thousands of workers, insurers’ and employers’ risk is spread across a much larger “pool” of people. A few employees getting sick or injured in a given year at a big company would have a negligible effect on the risk pool.

Not so at a shop like Roach’s with just a dozen workers. Small business owners pay more because underwriters at insurance companies know that if just one worker at a small business gets sick, the insurer could wind up losing money on the account. Small businesses also lack the bargaining power of large firms.

As a consequence, more and more small companies have dropped coverage in recent years while big employers have continued to offer it.

“Not offering health insurance puts a small business like ours us at a distinct disadvantage,” said Roach, “especially when you consider that we are competing to have the best employees we can have to provide the best customer service against crack competitors like Nordstrom’s.”

So when he heard that the Affordable Care Act makes tax credits available to small employers that offer coverage, he talked with his accountant, who told him that the tax credits would make coverage affordable—not cheap, but affordable—for the first time.

Another motivation: his store manager was considering taking a job with a competitor that offered benefits.

“We didn’t want to lose her, and she didn’t want to quit,” Roach said, but her husband had just lost his job. She needed to work for a company that offered coverage.

Roach decided to go for it. He now pays about $29,000 in premiums for his workers, but he has received tax credits that have averaged $5,000 over the past two years. And he’ll save even more next year.

Under the law, small businesses that employ fewer than 25 people whose average wages are less than $50,000 get a tax credit equivalent to 35 percent of the employers’ contribution to the workers’ premiums. It will go to 50 percent starting next year.

Also next year, companies with fewer than 100 employees will be able to buy coverage through the online health insurance marketplaces (referred to as exchanges in the ACA). This should make polices even more affordable because the exchanges will pool the purchasing power of small businesses together. And starting next year, insurers will no longer be able to dramatically increase small business health insurance premiums because an employee got sick or older or because the business hired more women, who historically have been charged more than men.

Companies with fewer than 50 employees will not have to offer coverage, but Roach says he believes many if not most will do so once the exchanges are up and running and more employers learn of the tax credits.

“I would really encourage every business to take a serious look at it because if you can do it, you’re going to have a better workforce,” Roach said. “The employees you’re going to have are going to feel better about coming to work. They are more likely to stay with you, and they’re probably going to be more productive because they’re not going to have to worry as much about access to health care.”

Most small employers that provide coverage typically offer only one type of plan because offering multiple options increases administrative costs. That, too, will change, thanks to the exchanges, meaning that employees like Mike Roach’s will eventually be able to choose among competing plans just like employees at many large firms. The effective date of that change was originally scheduled to be January 1, 2014, but the Department of Health and Human Services is considering delaying it for a year. Even if it is delayed, though, many small business employees already are getting employer-subsidized coverage for the first time. And companies like Paloma Clothing are finally on a more level playing field with their bigger competitors.